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. 41, No. 3, September 23, 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):
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
Statutory Authority
§§ 10.1-1402 and 10.1-1454.1 of the Code of Virginia.