CTR066290_-_Auto_WOS.pdf
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- Attached to
- Master Agreement AZ|CTR066290
- Contract number
- CTR066290
- Issued by
- Arizona
About this file
This document is a Commercial Auto Insurance Policy Endorsement for Waiver of Transfer of Rights of Recovery (Subrogation) issued to Old Concho Community Assistance Center, with an effective date of 11/12/2023. The endorsement specifically involves the State of Arizona, including its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees, and provides coverage related to work performed by or on behalf of the Contractor.
The endorsement modifies insurance coverage under Auto Dealers, Business Auto, and Motor Carrier Coverage Forms. Its primary purpose is to waive the insurer's right to seek recovery against the State of Arizona and its associated entities for losses arising from the Contractor's work. The policy number is 47-RWS-261285-03, and it applies to commercial automobile coverage, ensuring that the State of Arizona is protected from potential subrogation claims resulting from the insured's work activities.
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Text version
POLICY NUMBER: COMMERCIAL AUTO
CA 04 44 10 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US (WAIVER OF SUBROGATION)
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement.
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.
Named Insured:
Endorsement Effective Date:
SCHEDULE
Name(s) Of Person(s) Or Organization(s):
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization.
CA 04 44 10 13 Page 1 of 1c Insurance Services Office, Inc., 2011
47-RWS-261285-03
11/12/2023
Old Concho Community Assistance Center
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.
File details come from the government source that posted it. Updated .