PCS_insurance.pdf
PDF 4 MB Posted
- Attached to
- Master Agreement AZ|CTR079528
- Contract number
- CTR079528
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance issued by Crest Insurance Group for Paradigm Construction Services LLC, with Selective Insurance Company of the Southeast and American Builders Insurance Company serving as insurers. The certificate is issued for the Arizona Department of Administration - GSA, located in Phoenix, Arizona, and references the Marana Veterans Memorial Cemetery Expansion Project (Project #: PCS-25-062).
The insurance policy provides commercial general liability, automobile liability, umbrella liability, and workers' compensation coverage for Paradigm Construction Services LLC. The policy is effective from 9/19/2025 to 9/19/2026, with coverage limits including $1,000,000 per occurrence for general liability, $1,000,000 for automobile liability, and $1,000,000 for workers' compensation. The certificate specifies that the Arizona Department of Administration - GSA and others are included as additional insureds when required by written contract, with coverage applying to ongoing and completed operations. The policy is primary and non-contributory, with a waiver of subrogation provision.
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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
9/24/2025
Crest Insurance Group, LLC 100 S Mill Avenue, Suite 930 Tempe AZ 85281
Michelle Reif 888-881-5765 mreif@crestins.com
License#: 967026 Selective Insurance Company of the SE 39926 PARACON-01 American Builders Insurance Company 11240
Paradigm Construction Services LLC.
PO Box 551 4340 E Indian School Rd, #21 Phoenix AZ 85018
16765993
A X 1,000,000 X 500,000
15,000
X $0 DED 1,000,000
3,000,000 X X
Y Y S 2503497 9/19/2025 9/19/2026
3,000,000
A 1,000,000
X X
S 2503497 9/19/2025 9/19/2026
A X X 1,000,000S 2503497 9/19/2025 9/19/2026
1,000,000 X $0
B X
N
Y WCV 0339814 03 3/6/2025 3/6/2026
1,000,000
1,000,000
1,000,000
Certificate holder and others when required in a written contract or agreement are Additional Insured (General Liability) ongoing and completed operations.
Coverage is Primary & Non-Contributory when required in a written contract or agreement (General Liability, Workers’ Compensation). Waiver of Subrogation applies when required in a written contract or agreement (General Liability, Workers’ Compensation). This form is subject to all policy forms, terms, endorsements, conditions definitions & exclusions. Forms: CG7300 10/23, CG7988 10/23, WC000313 04/84.
REFERENCE: Marana Veterans Memorial Cemetery Expansion Project #: PCS-25-062 Arizona Department of Administration - GSA and others, if required by written contract, are included as Additional Insured and coverage applies per above and attached endorsements.
Arizona Department of Administration - GSA 1400 W Washington St, Ste B200 Phoenix AZ 85007
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