CTR066190_-_WC_WOS.pdf
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- Attached to
- Master Agreement AZ|CTR066190
- Contract number
- CTR066190
- Issued by
- Arizona
About this file
This document is a Workers Compensation and Employers Liability Insurance Policy Endorsement issued by CopperPoint Western Insurance Company for Catholic Charities Community Services Inc, with an effective date of 07/01/2023. The policy specifically involves the State of Arizona, including its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees. The endorsement is a Waiver of Right to Recover from Others, with Policy No. 1019020 and Endorsement No. 9.
The endorsement provides a blanket waiver for the insurance company's right to recover payments from parties liable for work-related injuries in the state of Arizona. This waiver applies specifically to work performed by or on behalf of the contractor, and it prevents the insurance company from pursuing recovery against the State of Arizona and its associated entities. The document outlines the terms under which the insurance company will not enforce its recovery rights, limited to situations where work is performed under a written contract requiring such an agreement.
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Text version
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13
(Ed. 4-84)
WC 00 03 13
(Ed. 4-84)
© 1983 National Council on Compensation Insurance.
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.)
07/01/2023Endorsement Effective 1019020Policy No. 9Endorsement No.
Catholic Charities Community Services IncInsured Premium $
CopperPoint Western Insurance CompanyInsurance Company Countersigned by
This document may have been uploaded to the CopperPoint Portal.
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 Blanket/Schedule/State
AZ The State of Arizona. its departments, agencies, boards, commissions, universities and its officers, officials, agents, and employees for losses arising from work perfromed by or on behalf of the Contractor
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