CTR066209_End_1_WestCare_Foundation_OPS1586865.pdf

PDF 133 KB Posted

Attached to
Master Agreement AZ|CTR066209
Contract number
CTR066209
Issued by
Arizona

About this file

This document is an insurance policy endorsement from Scottsdale Insurance Company for WestCare Foundation, Inc., effective 07/01/2025. The policy specifically includes the State of Arizona, along with its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees as additional insureds under a Commercial General Liability Coverage policy. The endorsement is numbered as Endorsement No. 1 and is associated with policy number OPS1586865, with Negley Associates serving as the agent.

The endorsement provides additional insured status to the State of Arizona for liability arising from WestCare Foundation's ongoing operations or premises. The coverage applies to bodily injury, property damage, or personal and advertising injury caused, in whole or in part, by WestCare Foundation's acts or omissions. The insurance is limited to the extent permitted by law and will not exceed the coverage required by any existing contract or agreement. The policy includes a waiver of subrogation, meaning Scottsdale Insurance Company waives its right to recover payments made for injury or damage arising from WestCare Foundation's operations. There is no additional premium charged for this endorsement, and the coverage is specifically tied to claims made against the named insured for their acts or omissions.

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Text version

ENDORSEMENT

NO. 1

ATTACHED TO AND

FORMING A PART OF

POLICY NUMBER

ENDORSEMENT EFFECTIVE DATE

(12:01 A.M. STANDARD TIME) NAMED INSURED AGENT NO.

OPS1586865

07/01/2025

WestCare Foundation, Inc.

Negley Associates

29518

COMMERCIAL GENERAL LIABILITY COVERAGE PART:

Forms CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US:

CLS-577-CGL(06-24) ADDITIONAL INSURED-DESIGNATED PERSON OR ORGANIZATION:

are hereby added to the policy, per attached.

No Additional Premium

UTS-3g (3-92) 08/08/2025 Dgallagher

POLICY NUMBER OPS1586865 COMMERCIAL GENERAL LIABILITY

CG 24 04 05 09

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY

AGAINST OTHERS TO US

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

SCHEDULE

Name Of Person Or Organization

State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents and employees

P.O. Box 501970

8710 Bash Street

Indianapolis, IN 46256

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 we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or “your work” done under a contract with that person or organization and included in the “products-completed operations hazard”. This waiver applies only to the person or organization shown in the Schedule above.

CG 24 04 05 09 © Insurance Services Office, Inc. 2008 Page 1 of 1

Underwritten by Scottsdale Insurance Company ENDORSEMENT

NO.

ATTACHED TO AND

FORMING A PART OF

POLICY NUMBER

ENDORSEMENT EFFECTIVE DATE

(12:01 A.M. STANDARD TIME) NAMED INSURED AGENT NO.

OPS1586865 07/01/2025 WestCare Foundation, Inc.

Negley Associates

29518

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED—DESIGNATED PERSON OR ORGANIZATION

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE

SCHEDULE

A. SECTION II—WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for “bodily injury,” “property damage” or “personal and advertising injury” caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf:

1. In the performance of your ongoing operations; or

2. In connection with your premises owned by or rented to you.

Coverage does not apply for any additional insured under this policy unless the liability of such additional insured arises from acts or omissions of the Named Insured while the Named Insured is performing services directly for such additional insured.

This insurance does not apply to the sole acts, errors or omissions of the additional insured. However:

1. The insurance afforded to such additional insured only applies to the extent permitted by law; and

2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured.

B. Coverage for the additional insured listed in this endorsement will apply only when a claim or “suit” for “bodily injury” or “property damage” or “personal and advertising injury” is also made and continuously maintained against the Named Insured for the Named Insured’s acts or omissions or the acts or omissions of those acting on behalf of the Named Insured which give rise to the liability of the additional insured.

Name Of Additional Insured Person(s) Or Organization(s)

State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents and employees P.O. Box 501970 8710 Bash Street

Indianapolis, IN 46256

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

CLS-577-CGL (06-24)

Includes copyrighted material of Insurance Services Office, Inc. with its permission.

C. With respect to the insurance afforded to these additional insureds, the following is added to SECTION

III—LIMITS OF INSURANCE:

If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance:

1. Required by the contract or agreement; or

2. Available under the applicable limits of insurance;

whichever is less.

This endorsement shall not increase the applicable limits of insurance.

All other terms and conditions remain as stated in the policy.

CLS-577-CGL (06-24)

Includes copyrighted material of Insurance Services Office, Inc. with its permission.

File details come from the government source that posted it. Updated .