JQF6326_State_of_AZ_COI_for_65482_and_63738.pdf
PDF 48 KB Posted
- Attached to
- Master Agreement AZ|CTR065482
- Contract number
- CTR065482
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance issued by Complete Equity Markets, Inc. on behalf of National Specialty Insurance Company for Disability Rights Arizona, located in Phoenix, Arizona. The certificate involves the State of Arizona's Department of Economic Security, with specific contract numbers CTR065482 and CTR063738. The certificate holder is the State of Arizona, Department of Economic Security, located at 100 N 15th Ave, Phoenix, AZ 85007.
The insurance policy provides Professional Liability coverage with policy number JQF6326, effective from 7/21/2025 to 7/21/2026. The policy includes an aggregate and per-claim limit of $5,000,000, and provides additional coverage for Sexual Misconduct Defense Costs of $250,000 per claim with a $250,000 aggregate limit. The policy extends additional insured status to the Arizona Department of Economic Security and the State of Arizona, including its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees, but only with respect to the operations of the named insured.
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Text version
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
INSURER(S) AFFORDING COVERAGE
INSURER F :
INSURER E :
INSURER D :
INSURER C :
INSURER B :
INSURER A :
NAIC #
NAME:
CONTACT
(A/C, No):
FAX
ADDRESS:
PRODUCER
(A/C, No, Ext):
PHONE
INSURED
REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
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).
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
OTHER:
(Per accident)
(Ea accident)
N / A
SUBR
WVD
ADDL
INSD
THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
$PROPERTY DAMAGE
BODILY INJURY (Per accident)
BODILY INJURY (Per person)
COMBINED SINGLE LIMIT
AUTOS ONLY
AUTOSAUTOS ONLY
NON-OWNED
SCHEDULEDOWNED
ANY AUTO
AUTOMOBILE LIABILITY
Y / N
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
DESCRIPTION OF OPERATIONS below If yes, describe under
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT
ER
OTH-
STATUTE
PER
LIMITS(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY)
POLICY EFF
POLICY NUMBERTYPE OF INSURANCELTR
INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EXCESS LIAB
UMBRELLA LIAB $EACH OCCURRENCE
$AGGREGATE
OCCUR
CLAIMS-MADE
DED RETENTION $
$PRODUCTS - COMP/OP AGG
$GENERAL AGGREGATE
$PERSONAL & ADV INJURY
$MED EXP (Any one person)
$EACH OCCURRENCE
DAMAGE TO RENTED
$PREMISES (Ea occurrence)
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO-
JECT LOC
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
Contract #CTR065482 and CTR#063738 Phoenix, AZ 85007 100 N 15th Ave Department of Economic Security State of Arizona
Subject to the terms, limits, conditions, exclusions, and endorsements of the policy of insurance, Arizona Department of Economic Security & The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents and employees are added to coverage as an additional insured(s), but only as respects the operations of the Named Assured.
Subject to the terms, limits, conditions, exclusions, and endorsements of the policy of insurance, we agree to waive any and all subrogation claims against the person or organization designated below except for the losses that are due in whole or part to the negligence or errors and omissions of the designated person or organization
Sexual Misconduct Defense Costs Coverage (Cost of Defense Only) $250,000 Each Claim/$250,000 Aggregate
$5,000,000Aggregate $5,000,000Each Claim7/21/20267/21/2025JQF6326XX
Professional Liability A
22608National Specialty Insurance Company
Phoenix, AZ 85034 5025 East Washington Street Suite 202 Disability Rights Arizona
(847)541-0444(847)541-0900
COMPLETE EQUITY MARKETS, INC
Lake Zurich, IL 60047 1190 Flex Court
COMPLETE EQUITY MARKETS INC
7/23/2025
File details come from the government source that posted it. Updated .