Virginia Administrative Code › Title 9 - ENVIRONMENT › Agency 20 - VIRGINIA WASTE MANAGEMENT BOARD › Chapter 170 - TRANSPORTATION OF SOLID AND MEDICAL WASTES ON STATE WATERS › Part VI - Financial Responsibility Requirements for Vessels Transporting Solid Wastes or Regulated Medical Wastes › Section 9VAC20-170-400:4 - APPENDIX IV

Current through Register Vol. 40, No. 24, July 15, 2024
(NOTE: Instructions in brackets are to be replaced with
					 the relevant information and the brackets deleted.)
ENDORSEMENT FOR LIABILITY COVERAGE.
1. This endorsement certifies that the policy
				  to which the endorsement is attached provides liability insurance covering
				  bodily injury and property damage in connection with the insured's obligation
				  to demonstrate financial responsibility under
				  9VAC20-170-330 of the
				  Transportation of Solid and Medical Waste on State Waters Regulations. The
				  coverage applies to the vessels listed on the attached Schedule A for sudden
				  accidental occurrences and/or nonsudden accidental occurrences. The limits of
				  liability are [insert the dollar amount of the "each occurrence" and "annual
				  aggregate" limits of the Insurer's liability], exclusive of legal defense
				  costs.
2. The insurance afforded
				  with respect to such occurrences is subject to all of the terms and conditions
				  of the policy; provided, however, that any provisions of the policy
				  inconsistent with subsections (a) through (e) of this Paragraph 2 are hereby
				  amended to conform with subsections (a) through (e):
(a) Bankruptcy or insolvency of the insured
				  shall not relieve the Insurer of its obligations under the policy to which this
				  endorsement is attached.
(b) The
				  Insurer is liable for the payment of amounts within any deductible applicable
				  to the policy, with a right of reimbursement by the insured for any such
				  payment made by the Insurer. This provision does not apply with respect to that
				  amount of any deductible for which coverage is demonstrated as specified in
				  9VAC20-170-330.
(c) Whenever requested by the Director of the
				  Department of Environmental Quality, Commonwealth of Virginia or the Regional
				  Administrator of the U.S. Environmental Protection Agency (EPA), the Insurer
				  agrees to furnish to the director or the Regional Administrator a signed
				  duplicate original of the policy and all endorsements.
(d) Cancellation of this endorsement, whether
				  by the Insurer, the insured, a parent corporation providing insurance coverage
				  for its subsidiary, or by a firm having an insurable interest in and obtaining
				  liability insurance on behalf of the owner or operator of a covered vessel,
				  will be effective only upon written notice and only after the expiration of 60
				  days after a copy of such written notice is received by the Director of the
				  Department of Environmental Quality, Commonwealth of Virginia.
(e) Any other termination of this endorsement
				  will be effective only upon written notice and only after the expiration of
				  thirty (30) days after a copy of such written notice is received by the
				  Director of the Department of Environmental Quality, Commonwealth of Virginia.
Attached to and forming part of policy No. ______ issued
					 by [name of Insurer], herein called the Insurer, of [address of Insurer] to
					 [name of insured] of [address] this ____ day of ______, 20__. The effective
					 date of said policy is ____ day of ______, 20__.
I hereby certify that the wording of this endorsement is
					 identical to the wording specified in the relevant regulations of the
					 Department of Environmental Quality, Commonwealth of Virginia, and that the
					 Insurer is licensed to transact the business of insurance, or eligible to
					 provide insurance as an excess or surplus lines insurer, in one or more
					 States.
[Signature of Authorized Representative of Insurer]
[Type name]
[Title], Authorized Representative of [name of
					 Insurer]
[Address of Representative]
SCHEDULE A
IDENTIFICATION OF COVERED VESSELS
Insurance Policy [insert policy number] is applicable to
					 the following vessels:
Vessel Name Gross tons Owner Operator