WESTCAREARIZONAIINC-PNC.pdf
PDF 229 KB Posted
- Attached to
- Master Agreement AZ|CTR066209
- Contract number
- CTR066209
- Issued by
- Arizona
About this file
This document is an insurance policy endorsement for a Commercial General Liability insurance policy issued by Allied World Surplus Lines Insurance Company to Westcare Foundation, Inc., with Policy Number 5088-0878-04. The policy includes additional insured status for the State of Arizona and Department of Economic Security (ADES), with administrative coordination through myCOI located in Indianapolis, IN. The endorsement is dated October 16, 2023, with a process date of October 23, 2023.
The endorsement modifies the insurance coverage to include both ongoing and completed operations, with a primary and non-contributory insurance condition. It provides liability coverage for bodily injury, property damage, and personal and advertising injury caused by Westcare Foundation's operations. The additional insured coverage applies to the State of Arizona and Department of Economic Security, with specific limitations on the extent and breadth of coverage. The policy ensures that the insurance will not be broader than what is required by contract or agreement, and the maximum payout will be the lesser of the amount required by contract or the available limits shown in the policy declarations.
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Text version
IL 12 01 11 85
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
IL 12 01 11 85 Copyright, Insurance Services Office, Inc., 1983 Copyright, ISO Commercial Risk Services, Inc., 1983
Page 1 of 1 o
POLICY CHANGES
Policy Change Number: 9
POLICY NUMBER
5088-0878-04
POLICY CHANGES
EFFECTIVE
10/16/2023
COMPANY
Allied World Surplus Lines Insurance Company
NAMED INSURED
Westcare Foundation, Inc.
AUTHORIZED REPRESENTATIVE
COVERAGE PARTS AFFECTED
Commercial Package
CHANGES
This policy is hereby endorsed to make the following changes:
Add:
Both Ongoing and Completed Operations
Completed Operations
Primary & Non-Contributory
All other terms and conditions remain the same.
Process Date: 10/23/2023
COMMERCIAL GENERAL LIABILITY
CG 20 01 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1
PRIMARY AND NONCONTRIBUTORY �
OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
The following is added to the Other Insurance Condition and supersedes any provision to the contrary:
Primary And Noncontributory Insurance
This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that:
(1) The additional insured is a Named Insured under such other insurance; and
(2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured.
POLICY NUMBER: 5088-0878-04 COMMERCIAL GENERAL LIABILITY
CG 20 10 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2
ADDITIONAL INSURED � OWNERS, LESSEES OR
CONTRACTORS � SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations
The State of Arizona and Dept of Economic Security
C/O: myCOI
Division Name: ADES.
1075 Broad Ripple Ave, Suite 313
Indianapolis, IN 46220
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
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:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your behalf;
in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above.
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. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:
This insurance does not apply to "bodily injury" or "property damage" occurring 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 location 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.
Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13
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 shown in the Declarations;
whichever is less.
This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.
POLICY NUMBER:5088-0878-04 COMMERCIAL GENERAL LIABILITY
CG 20 37 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2
ADDITIONAL INSURED � OWNERS, LESSEES OR
CONTRACTORS � COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations
The State of Arizona and Dept of Economic Security C/O: myCOI
1075 Broad Ripple Ave, Suite 313
Indianapolis, IN 46220
Division Name: ADES.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
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" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard".
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.
Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 37 04 13 o
B. 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 shown in the Declarations;
whichever is less.
This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.
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