CTR077356 Cetrificate of Insurance.pdf
PDF 2 MB Posted
- Attached to
- Master Agreement AZ|CTR077346
- Contract number
- CTR077346
- Issued by
- Arizona
About this file
This document is a Certificate of Garage Insurance for McGrath Companies, Inc. DBA Canyon State Bus Sales, located in Glendale, Arizona, with the State of Arizona or Arizona Department of Transportation as the certificate holder. The insurance is provided by multiple carriers including Travelers Indemnity Company of CT, Travelers Property Casualty Company of America, AmTrust North America, and Travelers Casualty Company of CT. The policy covers various liability and physical damage aspects for an auto dealership, with an effective period from November 1, 2024 to November 1, 2025.
The insurance provides comprehensive coverage including garage liability, commercial general liability, auto liability, workers' compensation, and physical damage protection. Key coverage details include a $1,000,000 auto liability limit, $3,000,000 general aggregate limit, and physical damage limits ranging from $60,000 to $1,548,000 across multiple locations. The policy includes additional insured status for the Arizona Department of Transportation, with coverage applying to all locations and operations. The insurance is primary and non-contributory, with a blanket waiver of subrogation, and extends to various operational risks inherent in an auto dealership, including incidental medical services and host liquor liability.
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Other files
| File | Type | Posted |
|---|---|---|
| 1-Confidentiality.pdf | ||
| 1-Financial Envelope-Proposal # 1-prop_answer.xls | XLS spreadsheet | |
| 1-Price Increase.pdf | ||
| 1-Boycott.pdf | ||
| 1-Forced Labor.pdf | ||
| CTR077346_Contract_Documents.pdf | ||
| CTR077346_Pricing.xlsx | XLSX spreadsheet | |
| 1-Offer Agreement.pdf | ||
| 1-Proposal # 1-prop_items.xls | XLS spreadsheet | |
| CTR077146_Contract_Administration.pdf | ||
| 1-BPM006654 Pricing.xlsx | XLSX spreadsheet | |
| 1-BPM006654_List_of_Subcontractor.xlsx | XLSX spreadsheet |
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Text version
PROD / CUSTOMER ID:
OTHER:
ER
OTH-
STATUTE
PER
LOC
LOC
LOC
OTC
LOC $
AUTO ONLY (Ea accident)
$AGGREGATE
ONLY
HIRED AUTOS
AUTOS ONLY
IN GARAGE
AUTOS USED
JECT
COLLISION
EXCESS
PERILS
SPECIFIED
PRIMARY
COMP /
DIRECT BASIS
LEGAL LIABILITY
GARAGE KEEPERS LIABILITY
$PRODUCTS - COMP/OP AGG
$GENERAL AGGREGATE
$PERSONAL & ADV INJURY
$MED EXP (Any one person)
$EACH OCCURRENCE
DAMAGE TO RENTED
$PREMISES (Ea occurrence)
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO- LOC
N / A
SUBR
WVD
ADDL
INSD
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
Y / N
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
REMARKS below If yes, describe under
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT
LIMITS(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY)
POLICY EFF
POLICY NUMBERTYPE OF INSURANCELTR
INSR
REMARKS (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EXCESS LIAB
UMBRELLA LIAB $EACH OCCURRENCE
$AGGREGATE
OCCUR
CLAIMS-MADE
DED RETENTION $
OTHER THAN
AUTO ONLY
$EA ACCIDENT
GARAGE LIABILITY
OWNED
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
INSURER(S) AFFORDING COVERAGE
INSURER F :
INSURER E :
INSURER D :
INSURER C :
INSURER B :
INSURER A :
NAIC #
NAME:
CONTACT
(A/C, No):
FAX
ADDRESS:
PRODUCER
(A/C, No, Ext):
PHONE
INSURED
REVISION #:CERTIFICATE #:COVERAGES
The ACORD name and logo are registered marks of ACORD
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
CERTIFICATE OF GARAGE INSURANCE
DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 30 (2016/03)
© 2010-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
NON-OWNED
BUSINESS
ANY AUTO
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
7/1/2025
Reseco Insurance Advisors, LLC 7901 N. 16th Street, Suite 100 Phoenix AZ 85020
602-753-4250 602-419-2242 certificates@resecoadvisors.com
Travelers Indemnity Company of CT 25682
McGrath Companies, Inc. DBA Canyon State Bus Sales 5600 W Claremont St Glendale AZ 85301
Travelers Property Casualty Co of Amer 25674 AmTrust North America 15954 Travelers Casualty Company of CT 36170
CANYONS-01 1160575092
A
X
X All Premise
AD-2X477670 11/1/2024 11/1/2025 1,000,000
1,000,000
3,000,000
A
X
1 150,000
X
X
X
AD-2X477670 11/1/2024 11/1/2025
3 2,000,000
D
X X Auto Dealers Lia
X
AD-2X477670 11/1/2024 11/1/2025 1,000,000
300,000
5,000
1,000,000
3,000,000
2,000,000
B X X
X 0
CUP-2X602332 11/1/2024 11/1/2025 10,000,000
10,000,000
C
N
Y KWC1376261 11/1/2024 11/1/2025 X
1,000,000
1,000,000
1,000,000 A Dealers Physical Damage AD-2X477670 11/1/2024 11/1/2025 Physical Damage Limit
Comprehensive Ded Collision Ded
See Below 10,000 10,000
Dealer's Physical Damage Limit Per Location:
o Location #1 $1,548,000 o Location #2 $ 60,000 See Attached...
The State of Arizona or Arizona Department of Transportation 1324 N 22nd Ave MD 128A Phoenix, AZ 85009
Cindy Lewis Accepted
ACORD 101 (2008/01)
The ACORD name and logo are registered marks of ACORD
© 2008 ACORD CORPORATION. All rights reserved.
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: FORM TITLE:
ADDITIONAL REMARKS
ADDITIONAL REMARKS SCHEDULE Page of
AGENCY CUSTOMER ID:
LOC #:
AGENCY
CARRIER NAIC CODE
POLICY NUMBER
NAMED INSURED
EFFECTIVE DATE:
CANYONS-01
1 1
Reseco Insurance Advisors, LLC McGrath Companies, Inc. DBA Canyon State Bus Sales 5600 W Claremont St Glendale AZ 85301
30 CERTIFICATE OF GARAGE INSURANCE
o Location #3 $4,300,000 o Location #4 $2,000,000 o Location #5 $2,000,000
Certificate holder is hereby included as Additional Insured with respects to the General Liability, and Excess/Umbrella Liability on a primary and non-contributory basis if required by written contract subject to all provisions and limitations of the policy. Waiver of Subrogation in favor of Certificate Holder applies to the General Liability, and Employers Liability/Workers Compensation if required by written contract subject to all provisions and limitations of the policy.
RE: insurance applies to any and all work performed for or on behalf of the State of Arizona or Arizona Department of Transportation
Additional Insured: State of Arizona or Arizona Department of Transportation
POLICY NUMBER: AD-2X477670
COMMERCIAL GENERAL LIABILITY
ISSUE DATE: 6/30/2025
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS~LESSEES OR
CONTRACTORS - SCHEDULED t'ERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Names of Additional Insured Person(s) or Organization(s):
Arizona Department of Transportation (ADOT)
Location of Covered Operations:
All Locations
(Information required to complete this Schedule, if not shown above, will be show n in the Declarations.)
A. Section 11 - Who Is An Insured is amended to include as an additional in sured the person(s ) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage", "personal injury" or "advertising injury" caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those act-ing on your behalf;
in the performance of your ongoing op erations for the addi tional insured(s) at the location(s) designated above.
B. With respect to the insurance afforded to these additional insureds, the follow ing additional exclusions apply:
This insurance does not apply to "bodily injury" or "property damage" occurring , or "personal injury" or "advertising in -jury" arising out of an offense commit -ted, after:
1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured (s) at the loca tion of the covered operations has been completed; or
2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project.
CG D3 61 0305 © 2005 The Travelers Companies, Inc. 2003 Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission.
Policy# AD-2X477670
Policy# AD-2X477670
COMMERCIAL AUTO
C. PHYSICAL DAMAGE - TRANSPORTATION
EXPENSE
The following is added to Paragraph F., Physical Damage Coverage, of SECTION I - COVERED
AUTOS COVERAGES:
Coverage Extension Transportation Expense We will pay up to $50 per day to a maximum of $1,500 for transportation expense incurred by you because of the total theft of a covered "auto". We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. We will pay for transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss".
If the transportation expense incurred arises from your rental of an "auto", the most we will pay is the amount it costs to rent an "auto" which is of the same like kind and quality as the stolen covered "auto".
D. DRIVE AWAY COLLISION
Exclusion Paragraph 3.d.(3) in Paragraph F., Physical Damage Coverage, of SECTION I - COVERED AUTOS COVERAGES relating to the transportation of vehicles more than 50 miles is deleted.
E. CUSTOMIZED FURNISHINGS
The following is added to Paragraph 4., Limits Of Insurance, in Paragraph F., Physical Damage Coverage, of SECTION I - COVERED
AUTOS COVERAGES:
The actual cash value, and the cost of repair or replacement, includes the value or cost to repair or replace customized furnishings the "insured" has made to a covered "auto" which improve the value of the covered "auto".
F. HOST LIQUOR LIABILITY
The following is added to Paragraph 1., Coverage, in Paragraph A., Bodily Injury And Property Damage Liability, of SECTION II -
GENERAL LIABILITY COVERAGES:
We will also pay all sums the "insured" legally must pay as damages because of "bodily injury" or "property damage" arising out of the giving or serving of alcoholic beverages at functions incidental to your "auto dealer operations" provided you are not engaged in the business of manufacturing, distributing, selling, serving or furnishing alcoholic beverages. Permitting a person to bring alcoholic beverages on your premises, for consumption on your premises, whether or not a fee is charged or a license is required for such activity, is not by itself considered the business of selling, serving or furnishing alcoholic beverages.
G. DAMAGE TO PREMISES RENTED TO YOU
1. The first paragraph of the exceptions in
Exclusion 2.e., Damage To Property, in Paragraph A., Bodily Injury And Property Damage Liability, of SECTION II - GENERAL LIABILITY COVERAGES is deleted.
2. The following replaces the last paragraph of Paragraph 2., Exclusions, of Paragraph A., Bodily Injury And Property Damage Liability, of SECTION II - GENERAL
LIABILITY COVERAGES:
Exclusions e.(1), (2) and (4), g. and o. do not apply to "premises damage". Exclusion f.(1)(a) does not apply to "premises damage" caused by fire. A separate limit of insurance applies to "premises damage" as described in Paragraph 5., in Paragraph F., Limits Of Insurance - General Liability Coverages, of SECTION II - GENERAL LIABILITY
COVERAGES-
3. The following replaces Paragraph 5. in Paragraph F., Limits Of Insurance - General Liability Coverages, of SECTION
II - GENERAL LIABILITY COVERAGES
Subject to Paragraph 4. above, the Damage To Premises Rented To You Limit is the most we will pay under Paragraph A. Bodily Injury And Property Damage Liability for damages because of "premises damage" to any one premises. The Damage To Premises Rented To You Limit will apply to all "property damage" proximately caused by the same "accident", whether such damage results from: fire; explosion; lightning; smoke resulting from such fire, explosion, or lightning; or water; or any combination of any of these causes.
The Damage To Premises Rented To You Limit will be:
a. The amount shown for the Damage To Premises Rented To You Limit on the Declarations of this Coverage Part; or
Page 2 of 5 © 2018 The Travelers Indemnity Company. All rights reserved. CAT4 251218 Includes copyrighted material of Insurance Services Office, Inc. with its permission.
b. $300,000 if no amount is shown for the Damage To Premises Rented To You Limit on the Declarations of this Coverage Part.
4. The fo II owing replaces Paragraph N.1. of the definition of "insured contract" in the DEFINITIONS Section:
1. A contract for a lease of premises.
However, that portion of the contract for a lease of premises that indemnifies any person or organization for "premises damage" is not an "insured contract";
5. The following is added to the DEFINITIONS Section:
"Premises damage" means "property damage" to:
1. Any premises while rented to you or temporarily occupied by you with permission of the own er; or
2. The contents of any premises while such premises is rented to you, if you rent such premises for a period of seven or fewer consecutive days.
6. The following replaces Paragraph 5.e.(1) in Paragraph B., General Conditions, of
SECTION IV - CONDITIONS:
(1) That is insurance for "premises damage";
7. Paragraph 5.e.(2) in Paragraph B., General Conditions, of SECTION IV - CONDITIONS is deleted.
H. INCIDENT AL MEDICAL MALPRACTICE
1. The following is added to the definition of
"accident" in the DEFINITIONS Section:
"Accident" also means an act or omission committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to a person.
2. The following is added to Paragraph 5.a. of Paragraph D., Who Is An Insured, of
SECTION II - GENERAL LIABILITY
COVERAGES:
Paragraph (4) above does not apply to "bodily injury" arising out of providing or failing to provide:
(a) "Incidental medical services" by any of your "employees" who is a nurse, nurse assistant, emergency medical technician, paramedic, athletic trainer, audiologist, dietician, nutritionist, occupational therapist or occupational
COMMERCIAL AUTO
therapy assistant, physical therapist or speech-language pathologist; or
(b) First aid or "Good Samaritan services" by any of your "employees", other than an employed doctor. Any such "employees" providing or failing to provide first aid or "Good Samaritan services" during their work hours for you will be deemed to be acting within the scope of their employment by you.
3. The following is added to Paragraph 4. in Paragraph F., Limits Of Insurance - General Liability Coverages, of SECTION
II - GENERAL LIABILITY COVERAGES:
For the purposes of determining the applicable Each "Accident" Lim it, all related acts or omissions committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to any one person will be deemed to be one "accident".
4. The following exclusion is added to Paragraph 2., Exclusions, in Paragraph A., Bodily Injury And Property Damage Liability, of SECTION II - GENERAL
LIABILITY COVERAGES:
Sale Of Pharmaceuticals "Bodily injury" or "property damage" arising out of the willful violation of a penal statute or ordinance relating to the sale of pharmaceuticals committed by, or with the knowledge or consent of, the insured.
5. The following is added to the DEFINITIONS Section:
"Incidental medical services" means:
1. Medical, surgical, dental, laboratory, x ray or nursing service or treatment, advice or instruction, or the related furnishing of food or beverages; or
2. The furnishing or dispensing of drugs or medical, dental, or surgical supplies or appliances.
"Good Samaritan services" means any emergency medical services for which no compensation is demanded or received.
6. The following is added to Paragraph 5.e., in Paragraph B., General Conditions, of
SECTION IV - CONDITIONS:
The insurance is excess over any valid and collectible other insurance available to the insured, whether primary, excess, contingent
CAT4 251218 © 2018 The Travelers Indemnity Company. All rights reserved. Page 3 of 5
COMMERCIAL AUTO
or on any other bas is, that is available to any of your "employees" for "bodily injury'' that arises out of providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to any person to the extent not subject to Paragraph 5.a. in Paragraph D .. Who Is An Insured, of Section 11- General Liability Coverages.
I. NON-OWNED WATERCRAFT
1. The following replaces Paragraph (2) of Exclusion g .. Aircraft, Auto Or Watercraft, in Paragraph 2 .. Exclusions, in Paragraph A .. Bodily Injury And Property Damage Liability of SECTION II - GENERAL
LIABILITY COVERAGES:
(2) A watercraft you do not own that is:
(a) Fifty feet long or less; and
(b) Not being used to carry any person or property for a charge; or
2. The following is added to Paragraph D .. Who Is An Insured, of SECTION II - GENERAL
LIABILITY COVERAGES:
Any person who, with your expressed or implied consent, uses or is responsible for the use of a watercraft you do not own that is:
a. Fifty feet long or less, and is not being used to carry any person or property for a charge; or
b. Ashore on premises where you conduct "auto dealer operations".
3. The following is added to Paragraph 5 ..
Other Insurance, in Paragraph B .. General Conditions, of SECTION IV
CONDITIONS:
This Coverage Form's Bodily Injury And Property Damage Liability Coverage for non owned watercraft is not applicable, and we will not make any payment, if there is other applicable insurance covering such watercraft.
J. NEWLY ACQUIRED OR FORMED AUTO
DEALERSHIP-180 DAYS
The following replaces Paragraph 6.a. in Paragraph D .. Who Is An Insured, in Paragraph A.. Bodily Injury And Property Damage Liability, of SECTION II - GENERAL LIABILITY
COVERAGES:
a. Coverage under this provIsIon is afforded only until the 180th day after you acquire or form the "auto" dealership or the end of the policy period, whichever is earlier; and
K. NOTICE AND KNOWLEDGE OF ACCIDENT,
OFFENSE, LOSS OR ACT, ERROR OR
OMISSION
The following is added to Paragraph A.2.a ..
Duties In The Event Of Accident, Claim, Suit, Loss Or Acts, Errors Or Omissions, of
SECTION IV - CONDITIONS:
Your duty to give us or our authorized representative prompt notice of the "accident", offense, "loss" or "act error or omission" applies only when the "accident", offense, "loss" or "act error or omission" is known to:
(5) You (if you are an individual);
(6) A partner (if you are a partnership);
(7) A member (if you are a limited liability company);
(8) An executive officer, director or insurance manager (if you are a corporation or other organization); or
(9) Any "employee" authorized by you to give such notice.
However, if this Coverage Part includes an endorsement that provides limited coverage for "bodily injury" or "property damage" or pollution costs arising out of a discharge, release or escape of "pollutants" which contains a requirement that the discharge, release or escape of "pollutants" must be reported to us within a specific number of days after its abrupt commencement, this Paragraph a. does not affect that requirement.
L. BLANKET WAIVER OF SUBROGATION
The following replaces the first paragraph of Paragraph A.5.. Transfer Of Rights Of Recovery Against others To Us, of SECTION
IV - CONDITIONS:
We waive any right of recovery we may have against any person or organization to the extent required of you by a written contract signed and executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by such contract.
The waiver applies only to the person or organization designated in such contract.
Page 4 of 5 © 2018 The Travelers Indemnity Company. All rights reserved. CAT4 251218 Includes copyrighted material of Insurance Services Office, Inc. with its permission.
Cindy Lewis Highlight
M. UNINTENTIONAL ERRORS OR OMISSIONS
The following is added to Paragraph B.2., Concealment, Misrepresentation, Or Fraud, of
SECTION IV - CONDITIONS:
The unintentional omission of, or unintentional error in, any information given by you will not prejudice your rights under this insurance.
However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal.
N. LIMITED WORLDWIDE LIABILITY COVERAGE
- INDEMNITY BASIS
1. The following is added to Paragraph B.7., Policy Period, Coverage Territory, of
SECTION IV - CONDITIONS:
The coverage territory described in Paragraph (S)(a) also applies with respect to any claim made or "suit" brought outside the United States of America, the territories or possessions of the United States of America Puerto Rico or Canada. However, for such claim or "suit":
(a) The following apply:
(i) You must arrange to defend the "insured" against, and investigate or settle any such claim or "suit" and keep us advised of all proceedings and actions.
(ii) Neither you nor any other involved "insured" will make any settlement without our consent.
(iii) We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit".
(iv) We will reimburse the "insured" for sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "insured" pays with our consent, but only up to the limit described in Paragraph F., Limits Of Insurance - General Liability Coverages, of
SECTION II - GENERAL LIABILITY
COVERAGES.
COMMERCIAL AUTO
(v) We will reimburse the "insured" for the reasonable expenses incurred with our consent for your investigation of such claims and your defense of the "insured" against any such "suit", but only up to and included within the limit described in Paragraph F., Limits Of Insurance - General Liability Coverages, of
SECTION II - GENERAL LIABILITY
COVERAGES, and not in addition to such limit. Our duty to make such payments ends when we have used up the applicable limit of insurance in payments for damages, settlements or defense expenses.
(b) This insurance is excess over any valid and collectible other insurance available to the "insured" whether primary, excess contingent or on any other basis.
(c) This insurance is not a substitute for required or compulsory insurance in any country outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada.
You agree to maintain all required or compulsory insurance in any such country up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory insurance requirements.
(d) It is understood that we are not an admitted or authorized insurer outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance.
CAT4 251218 © 2018 The Travelers Indemnity Company. All rights reserved. Page 5 of 5
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
WC 00 0313
(Ed. 04-84)
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
Any person or organization as required by written contract
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 Insured Insurance Company
WC 00 0313
(Ed. 04-84)
11/1/2024 Policy No. KWC1376261 McGrath Companies, Inc.
AmTrust Insurance Company
Endorsement No. 0
Countersigned by _________________ _
File details come from the government source that posted it. Updated .