CTR066209-WOS.pdf

This document is a Workers Compensation and Employers Liability Insurance Policy Waiver of Right to Recover from Others Endorsement, issued by Berkshire Hathaway Homestate Insurance Company. The policy covers the State of Arizona, including its departments, agencies, boards, commissions, universities, officers, officials, and employees. The endorsement is effective from 03/01/2024 and is associated with Policy No. WEWC519890.

The endorsement specifically provides a waiver for losses arising from work performed by or on behalf of the contractor, with a class code 8864 for the state of Arizona. The waiver premium is listed as NA (not applicable), and the payroll subject to waiver is also marked as NA. The document outlines the insurance company's agreement not to enforce recovery rights against persons or organizations named in the Schedule, to the extent that work is performed under a written contract requiring such an agreement.