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  "id": "sierra-madre-waiver-of-subrogation-sample-packet",
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  "contentVersion": "2026.08.31",
  "generatedFor": "2026-09-06",
  "operator": {
    "legalName": "WJB Services, Inc.",
    "dba": "Bollinsure Insurance Services",
    "license": "6013787",
    "licenseAuthority": "California Department of Insurance"
  },
  "license": "Text on this page may be quoted with attribution and a link to the canonical URL.",
  "notice": "Public page facts only. This record contains no visitor question, no tool input, and no identifier. It is not a coverage determination, an eligibility decision, or individualized advice.",
  "title": "Acceptable Waiver Of Subrogation Endorsements (municipal sample packet reproducing CG 24 04 05 09 and WC 04 03 06)",
  "publisher": "City of Sierra Madre, California",
  "url": "https://www.sierramadreca.gov/media/fg4hgcis/acceptable-waiver-of-subrogation-endorsements.pdf",
  "officialHost": true,
  "sourceType": "policy-form",
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  "primary": false,
  "jurisdiction": "CA",
  "publishedDate": "unknown",
  "effectiveDate": "n/a",
  "accessedDate": "2026-08-31",
  "lastChecked": "2026-08-31",
  "updateCadence": "The city may revise its sample packet at any time; the underlying forms are revised by their own filers.",
  "status": "active",
  "supportsClaims": [
    {
      "claimId": "sierra-madre-waiver-of-subrogation-sample-packet#c1",
      "canonicalUrl": "https://bestinsuranceresearch.com/sources/sierra-madre-waiver-of-subrogation-sample-packet#c1",
      "checksum": "21762ce15724",
      "text": "The packet reproduces ISO form CG 24 04 05 09, 'Waiver Of Transfer Of Rights Of Recovery Against Others To Us', which adds the following to Paragraph 8, Transfer Of Rights Of Recovery Against Others To Us, of Section IV - Conditions: 'We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or \"your work\" done under a contract with that person or organization and included in the \"products-completed operations hazard\". This waiver applies only to the person or organization shown in the Schedule above.' The reproduced form carries the footer 'Insurance Services Office, Inc., 2008'."
    },
    {
      "claimId": "sierra-madre-waiver-of-subrogation-sample-packet#c2",
      "canonicalUrl": "https://bestinsuranceresearch.com/sources/sierra-madre-waiver-of-subrogation-sample-packet#c2",
      "checksum": "2ad70a0587d0",
      "text": "The packet reproduces form WC 04 03 06 (Ed. 04/84), 'Waiver Of Our Right To Recover From Others Endorsement - California', which carries the same waiver sentence as WC 00 03 13 and adds: 'You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule' and 'The additional premium for this endorsement shall be _____% of the California workers compensation premium otherwise due on such remuneration.' The percentage is a blank field on the form; no figure is stated."
    },
    {
      "claimId": "sierra-madre-waiver-of-subrogation-sample-packet#c3",
      "canonicalUrl": "https://bestinsuranceresearch.com/sources/sierra-madre-waiver-of-subrogation-sample-packet#c3",
      "checksum": "fd1d71c09ede",
      "text": "The packet presents waiver of subrogation endorsements under their own heading, separate from additional insured endorsements, and describes CG 24 04 as providing 'a specific waiver of subrogation for the designated person or organization, barring suit by the company which assumes the insured's rights after loss payment.'"
    }
  ],
  "reliedOnBy": [
    {
      "kind": "Question",
      "title": "When can a contract require additional insured status?",
      "url": "https://bestinsuranceresearch.com/questions/contract-additional-insured-status"
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    {
      "kind": "Module",
      "title": "Contract Insurance Requirements (1 check)",
      "url": "https://bestinsuranceresearch.com/tools/contract-requirements"
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  "reliedOnByCount": 2,
  "citation": {
    "text": "City of Sierra Madre, California. \"Acceptable Waiver Of Subrogation Endorsements (municipal sample packet reproducing CG 24 04 05 09 and WC 04 03 06).\" unknown. https://www.sierramadreca.gov/media/fg4hgcis/acceptable-waiver-of-subrogation-endorsements.pdf (retrieved 2026-08-31).",
    "viaThisSite": "BestInsurance Research source record sierra-madre-waiver-of-subrogation-sample-packet, content version 2026.08.31. https://bestinsuranceresearch.com/sources/sierra-madre-waiver-of-subrogation-sample-packet",
    "note": "Cite the underlying source when you can. Cite this record when you are describing our synthesis or our claim list."
  }
}