Authority: IC 13-14-8; IC 13-22-2; IC 13-22-8-1; IC 13-22-9-7
Affected: IC 13-22
Sec. 35.
A hazardous waste facility liability endorsement, as required in section 24 of this rule or 329 IAC 3.1 15-8, 329 IAC 3.1-15-10(i)) , must be worded as follows except that instructions in brackets are to be replaced with the relevant information and the brackets deleted:
Hazardous Waste Facility Liability Endorsement
Attached to and forming part of policy number _____ issued by [name of Insurer], herein called the Insurer, of
[address of Insurer] to [name of insured] of [address] this _____ day of _____, [year]. The effective date of said policy is _____ day of ____, [year].
I hereby certify that the wording of this endorsement is identical to the wording specified in 329 IAC 3.1-14-35 as such rule was constituted on the date first above written, 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 (1) or more states.
[Signature of authorized representative of Insurer]
[Type name]
[Title], Authorized Representative of [name of Insurer]
[Address of representative]
329 IAC 3.1-14-35