CTR065009_-_WC_WOS__1_.pdf
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- Attached to
- Master Agreement AZ|CTR065009
- Contract number
- CTR065009
- Issued by
- Arizona
About this file
This document is a Workers Compensation and Employers Liability Insurance Policy Waiver of Right to Recover from Others Endorsement issued by ARCH INSURANCE COMPANY for AARP Premium INCL., with an effective date of 07/01/2024. The policy specifically covers the STATE OF ARIZONA, including its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees for losses arising from work performed by or on behalf of the contractor.
The endorsement provides a waiver of subrogation, which means the insurance company agrees not to enforce its right to recover payments from the entities listed in the Schedule, but only to the extent that work is performed under a written contract requiring such an agreement. There are specific provisions for Missouri, where the waiver does not apply to certain construction classification groups. The policy number is 11WCI4937117, with a date of issue of 07-08-24, and includes standard protections and limitations typical of workers' compensation insurance policies.
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Text version
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
Endorsement Effective 07/01/2024 Policy No. 11WCI4937117 Endorsement No.
Insured AARP Premium INCL.
Insurance Company ARCH INSURANCE COMPANY
Countersigned By
POLICY NUMBER: 11WCI4937117
DATE OF ISSUE: 07-08-24
WC 00 03 13
(Ed. 4-84)
1983 National Council on Compensation Insurance.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13
(Ed. 4-84)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.)
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
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
For policies or exposure in Missouri:
Any person or organization for which the employer has agreed by written contract, executed prior to loss, may execute a waiver of subrogation. However, for purposes of work performed by the employer in Missouri, this waiver of subrogation does not apply to any construction group of classifications as designated by the waiver of right to recover from others (subrogation) rule in our manual.
File details come from the government source that posted it. Updated .