CTR065009_-_CGL_WOS__1_.pdf
PDF 191 KB Posted
- Attached to
- Master Agreement AZ|CTR065009
- Contract number
- CTR065009
- Issued by
- Arizona
About this file
This document is a Commercial General Liability insurance policy endorsement with a waiver of transfer of rights of recovery (subrogation), issued by Insurance Services Office, Inc. The policy specifically names The State of Arizona, including its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees as the covered entity, with a mailing address in Phoenix, Arizona.
The endorsement modifies various liability coverage parts, including commercial general liability, electronic data liability, liquor liability, pollution liability, products/completed operations liability, railroad protective liability, and underground storage tank policy. The key provision is a waiver of the insurance carrier's right of recovery against the named Arizona state entities for losses arising from work performed by or on behalf of the contractor, contingent upon the insured having waived its own right of recovery prior to the loss.
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Text version
CG 24 04 12 19 © Insurance Services Office, Inc., 2018 Page 5 of 8
POLICY NUMBER: 11GPP4936917 COMMERCIAL GENERAL LIABILITY
CG 24 04 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US (WAIVER OF SUBROGATION)
COMMERCIAL GENERAL LIABILITY COVERAGE PART
ELECTRONIC DATA LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES
POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS
SCHEDULE
Name Of Person(s) Or Organization(s):
THE STATE OF ARIZONA, AND ITS DEPARTMENTS, AGENCIES, BOARDS,
COMMISSIONS, UNIVERSITIES, OFFICERS, OFFICIALS, AGENTS, AND EMPLOYEES
FOR LOSSES ARISING FROM WORK PERFORMED BY OR ON BEHALF OF THE
CONTRACTOR.
P.O. BOX 6123
PHOENIX, AZ 85005
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV – Conditions:
We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above.
This endorsement modifies insurance provided under the following:
File details come from the government source that posted it. Updated .