2026-3-19_COI_CTR077220_CGL_WC_PL_AUTO__1_.pdf
PDF 442 KB Posted
- Attached to
- Master Agreement AZ|CTR077220
- Contract number
- CTR077220
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance issued on behalf of Steadfast Construction LLC dba Steadfast Renovations LLC (335 Merit Court, Henderson, NV 89014) to the State of Arizona, Department of Economic Security, serving as the certificate holder. The insurance was produced by Stampede Insurance Services, Inc. and is dated July 10, 2025, corresponding to Contract ID CTR077220. The certificate documents multiple insurance policies underwritten by Scottsdale Insurance Company, National General Insurance Company, Clear Spring Property & Casualty, and Certain Underwriters at Lloyd's, London.
The insurance coverage includes Commercial General Liability with limits of $1,000,000 per occurrence and $2,000,000 general aggregate; Automobile Liability with a $1,000,000 combined single limit per occurrence; Excess/Umbrella Liability with $2,000,000 per occurrence and aggregate limits; Workers Compensation with statutory limits and Employers' Liability limits of $1,000,000 per accident and per disease; and Professional Liability/Errors & Omissions with $2,000,000 per occurrence and aggregate limits. All policies include waivers of subrogation and name the State of Arizona and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees as additional insureds. Policy effective dates range from March 19, 2025 to July 10, 2026, with coverage extending through June 17, 2026 for professional liability.
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Text version
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
07/10/2025
PRODUCER
Stampede Insurance Services, Inc.
40 N. Altadena Drive, Ste. 205
Pasadena, CA 91107
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC #
INSURED
Steadfast Construction LLC dba Steadfast Renovations LLC
335 Merit Court
Henderson, NV 89014
INSURER A: Scottsdale Insurance Company 41297
INSURER B: National General Insurance Company 23728
INSURER C: Scottsdale Insurance Company 41297
INSURER D: Clear Spring Property & Casualty 15563
INSURER E: Certain Underwriters at Lloyd's, London 15792
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TYPE OF INSURANCE POLICY NUMBER
POLICY EFFECTIVE
DATE (MM/DD/YY)
POLICY EXPIRATION
DATE (MM/DD/YY)
LIMITS
A
GENERAL LIABILITY
COMMERICAL GENERAL LIABILITY
CLAIMS MADE OCCUR
Waiver of Subrogation
GEN’L AGGREGATE LIMIT APPLIES PER:
POLICY PROJECT LOC
RBS0332329 03/19/2025 03/19/2026
EACH OCCURENCE $1,000,000
DAMAGE TO RENTED
PREMISES (Ea occurrence) $100,000
MED EXP (Any one person) $5,000
PERSONAL & ADV INJURY $1,000,000
GENERAL AGGREGATE $2,000,000
PRODUCTS - COMP/OP AGG $2,000,000
B
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
2029890735 07/10/2025 07/10/2026 COMBINED SINGLE LIMIT
(Each Occurrence) $1,000,000
BODILY INJURY
(Per person) $
BODILY INJURY
(Per accident) $
PROPERTY DAMAGE
(Per accident) $
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT $
OTHER THAN
AUTO ONLY:
EA ACC $
AGG $
C
EXCESS/UMBRELLA LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
XLS1229020 03/19/2025 03/19/2026
EACH OCCURRENCE $2,000,000
AGGREGATE $2,000,000
D
WORKERS COMPENSATION AND
EMPLOYERS’ LIABILITY
ANY PROPRIETOR/PARTNER/EXECU-
TIVE OFFICER/MEMBER EXCLUDED?
If yes, describe under SPECIAL PROVISIONS below
CWC00597203 03/19/2025 03/19/2026
WC STATU-
TORY LIMITS
OTH-
ER
E.L. EACH ACCIDENT $1,000,000
E.L. DISEASE - EA EMPLOYEE $1,000,000
E.L. DISEASE - POLICY LIMIT $1,000,000
E
OTHER
Professional Liability /
Errors & Omissions
ATRPL281425 06/17/2025 06/17/2026 Each Occurrence
Aggregate Limit
$2,000,000
$2,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are listed as an Additional Insured. Sexual
Abuse and Molestation coverage is not excluded with respect to the General Liability coverage.
Contract ID: CTR077220
CERTIFICATE HOLDER CANCELLATION
The State of Arizona and Dept of Economic Security c/o myCOI
P.O. Box 501970 8710 Bash Street
Indianapolis, IN 46256
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO
MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2001/08) © ACORD CORPORATION 1988
INSR
LTR
ADD’L
INSRD
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contact between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25 (2001/08)
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
06/17/2025
PRODUCER
Stampede Insurance Services, Inc.
40 N. Altadena Drive, Ste. 205
Pasadena, CA 91107
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC #
INSURED
335 Merit Court
Henderson, NV 89014
INSURER A: Scottsdale Insurance Company 41297
INSURER B:
INSURER C: Scottsdale Insurance Company 41297
INSURER D: Clear Spring Property & Casualty 15563
INSURER E: Certain Underwriters at Lloyd's, London 15792
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TYPE OF INSURANCE POLICY NUMBER
POLICY EFFECTIVE
DATE (MM/DD/YY)
POLICY EXPIRATION
DATE (MM/DD/YY)
LIMITS
A
GENERAL LIABILITY
COMMERICAL GENERAL LIABILITY
CLAIMS MADE OCCUR
Waiver of Subrogation
GEN’L AGGREGATE LIMIT APPLIES PER:
POLICY PROJECT LOC
RBS0332329 03/19/2025 03/19/2026
EACH OCCURENCE $1,000,000
DAMAGE TO RENTED
PREMISES (Ea occurrence) $100,000
MED EXP (Any one person) $5,000
PERSONAL & ADV INJURY $1,000,000
GENERAL AGGREGATE $2,000,000
PRODUCTS - COMP/OP AGG $2,000,000
AUTOMOBILE LIABILITY
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
COMBINED SINGLE LIMIT
(Each Occurrence) $
BODILY INJURY
(Per person) $
BODILY INJURY
(Per accident) $
PROPERTY DAMAGE
(Per accident) $
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT $
OTHER THAN
AUTO ONLY:
EA ACC $
AGG $
C
EXCESS/UMBRELLA LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
XLS1229020 03/19/2025 03/19/2026
EACH OCCURRENCE $2,000,000
AGGREGATE $2,000,000
D
WORKERS COMPENSATION AND
EMPLOYERS’ LIABILITY
ANY PROPRIETOR/PARTNER/EXECU-
TIVE OFFICER/MEMBER EXCLUDED?
If yes, describe under SPECIAL PROVISIONS below
CWC00597203 03/19/2025 03/19/2026
WC STATU-
TORY LIMITS
OTH-
ER
E.L. EACH ACCIDENT $1,000,000
E.L. DISEASE - EA EMPLOYEE $1,000,000
E.L. DISEASE - POLICY LIMIT $1,000,000
E
OTHER
Professional Liability /
Errors & Omissions
ATRPL281425 06/17/2025 06/17/2026 Each Occurrence
Aggregate Limit
$1,000,000
$2,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees are listed as an Additional Insured. Sexual
Abuse and Molestation coverage is not excluded with respect to the General Liability coverage.
Contract ID: CTR077220
CERTIFICATE HOLDER CANCELLATION
The State of Arizona and Dept of Economic Security c/o myCOI P.O. Box 501970
8710 Bash Street
Indianapolis, IN 46256
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO
MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2001/08) © ACORD CORPORATION 1988
INSR
LTR
ADD’L
INSRD
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contact between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25 (2001/08)
POLICY NUMBER: COMMERCIAL AUTO
CA 04 44 10 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CA 04 44 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US (WAIVER OF SUBROGATION)
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement.
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.
Named Insured:
Endorsement Effective Date:
SCHEDULE
Name(s) Of Person(s) Or Organization(s):
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization.
State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees
2029890735
07/10/2025
COMMERCIAL GENERAL LIABILITY
CG 24 04 05 09
CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
SCHEDULE
Name Of Person Or Organization:
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The following is added 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.
POLICY NUMBER: RBS0332329
COMMERCIAL CRIME LIABILITY COVERAGE PART
State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13
(Ed. 4-84)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.)
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
Endorsement Effective Policy No. Endorsement No.
Insured Premium
Insurance Company Countersigned by___________________________________________
WC 00 03 13
(Ed. 4-84)
State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees.
Steadfast Construction LLC
Clear Spring Property and Casualty Company
INCL.
CWC0059720303/19/2025 01
© 1983 National Council on Compensation Insurance.
| CTR077220 COI_Arizona Department of Economic Security |
| CTR077220 COI_Arizona Department of Economic Security_V3 |
| CTR077220 CA 0444 1013_WOS_ADES |
| CTR077220 CG 2404 form Waiver_Arizona DES |
| CTR077220 WC001333 form Waiver_Arizona DES |
| WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT |
File details come from the government source that posted it. Updated .