CTR067100-COI-CAuWcUm-Exp-1.4.2026pdf.pdf

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Master Agreement AZ|CTR067100
Contract number
CTR067100
Issued by
Arizona

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This is a Certificate of Liability Insurance for Viking Specialty Services LLC dba Viking Specialty Contracting, issued by multiple insurers including GuideOne National Insurance Company, Secura Insurance, and Travelers Property Casualty Company of America. The certificate is issued for a contract with the Arizona Department of Environmental Quality, specifically for Solicitation No. BPM004287 for Asbestos and Lead Consultant and Abatement Services. The contract number is CTR067100, and the insurance provides coverage for the State of Arizona, its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees.

The insurance policy covers multiple types of liability, including Commercial General Liability, Automobile Liability, Umbrella Liability, Workers' Compensation, Contractors Pollution Liability, and Consultants Professional Liability. The policy periods run from January 4, 2025, to January 4, 2026, with various coverage limits. For Commercial General Liability, the each occurrence limit is $1,000,000, with a general aggregate of $2,000,000. The policy includes additional insured endorsements, primary and non-contributory coverage, and waiver of subrogation provisions. Specific coverage includes leased/rented equipment, with limit/deductible details of $200,000/$500, and professional liability with a $1,000,000/$2,500 limit/deductible structure.

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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

E-MAIL

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

10/14/2025

Breinholt Anderson Insurance Consultants LLC 4140 E. Baseline Road, Suite 201 Mesa AZ 85206

Heather Glancy 480-935-7000 480-935-7009 certificates@baicins.com

GuideOne National Insurance Company 14167 VIKISPE-01 Secura Insurance 22543

Viking Specialty Services LLC dba Viking Specialty Contracting 1008A E. Vista Del Cerro Dr Tempe AZ 85281

Travelers Property Casualty Company of America 25674

1249160088

A X 1,000,000 X 100,000

5,000

1,000,000

2,000,000 X X

Y Y ENV56201795200 1/4/2025 1/4/2026

2,000,000

B 1,000,000

X Y Y A3327931 8/10/2025 8/10/2026

A X 5,000,000 X

ENV56201795300 1/4/2025 1/4/2026

5,000,000 X 0

C X

N

6JUBA3794797 1/4/2025 1/4/2026

1,000,000

1,000,000

1,000,000 B A

Leased/Rented Equipment Contractors Pollution Liability Consultants Professional Liab

CP3327930

ENV56201795200

8/10/2025 1/4/2025

8/10/2026 1/4/2026

Limit/Deductible Limit/Deductible Limit/Deductible

$200,000/$500 $1,000,000/$2,500 $1,000,000/$2,500

The General Liability and Business Auto policies include an automatic Additional Insured endorsement that provides Additional Insured status to the Certificate Holder and any additional entities listed, if any, only when there is a written contract that requires such status, and only with regard to work performed on behalf of the named insured. The General Liability and Business Auto policies contain the endorsement with Primary and Noncontributory wording, when required by written contract. The General Liability and Business Auto policies provide a Waiver of Subrogation when required by written contract. The Excess Liability policy follows form to the General Liability, Professional Liability, Pollution Liability, and Business Auto policies.

RE: RE: Solicitation No. BPM004287 Asbestos and Lead Consultant and Abatement Services.

Additional Insureds include: State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees Contract #: CTR067100

Arizona Department of Environmental Quality 1110 W Washington St Phoenix AZ 85007

POLICY NUMBER: ENV562017952-00 COMMERCIAL GENERAL LIABILITY

CG 20 10 07 04

CG 20 10 07 04 © ISO Properties, Inc., 2004. Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED - OWNERS, LESSEES OR

CONTRACTORS - SCHEDULED PERSON OR

ORGANIZATION

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

Name Of Additional Insured Person(s) Or Organization(s):

Location(s) Of Covered Operations

Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement, effected prior to the date your operations for that person or organization commenced, that such person or organization be added as an additional insured on your policy.

In respect to any location where the named insured is performing “your work”.

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by:

1. Your acts or omissions; or

2. The acts or omissions of those acting on your behalf;

in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above.

B. With respect to the insurance afforded to these additional insureds, the following additional exclu-sions apply:

This insurance does not apply to "bodily injury" or "property damage" occurring after:

1. All work, including materials, parts or equip-ment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or

2. That portion of "your work" out of which the injury or damage arises has been put to its in-tended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project.

POLICY NUMBER: ENV562017952-00 COMMERCIAL GENERAL LIABILITY

CG 20 37 07 04

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1

ADDITIONAL INSURED – OWNERS, LESSEES OR

CONTRACTORS – COMPLETED OPERATIONS

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Operations

Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement, effected prior to the date your operations for that person or organization commenced, that such person or organization be added as an additional insured on your policy.

In respect to any location where the named insured is performing “your work”.

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

Section II – Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard".

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Policy #ENV56201795200

CG 25 03 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 2

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

Designated Construction Project(s):

Any project when the Named Insured agrees, in a written contract, to provide a separate Designated Construction Project General Aggregate Limit.

However, this status exists only for the project specified in that contract.

In no event shall the Aggregate Limit of Insurance provided by this endorsement exceed $5,000,000 in total.

COMMERCIAL GENERAL LIABILITY

CG 25 03 05 09

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

DESIGNATED CONSTRUCTION PROJECT(S)

GENERAL AGGREGATE LIMIT

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

A. For all sums which the insured becomes legally obligated to pay as damages caused by "occur-rences" under Section I – Coverage A, and for all medical expenses caused by accidents under Section I – Coverage C, which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above:

1. A separate Designated Construction Project

General Aggregate Limit applies to each des-ignated construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations.

2. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under Coverage A, ex-cept damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard", and for medi-cal expenses under Coverage C regardless of the number of:

a. Insureds;

b. Claims made or "suits" brought; or

c. Persons or organizations making claims or bringing "suits".

3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Designated Con-struction Project General Aggregate Limit for that designated construction project. Such payments shall not reduce the General Ag-gregate Limit shown in the Declarations nor shall they reduce any other Designated Con-struction Project General Aggregate Limit for any other designated construction project shown in the Schedule above.

4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply.

However, instead of being subject to the General Aggregate Limit shown in the Decla-rations, such limits will be subject to the appli-cable Designated Construction Project Gen-eral Aggregate Limit.

Page 2 of 2 © Insurance Services Office, Inc., 2008 CG 25 03 05 09

B. For all sums which the insured becomes legally obligated to pay as damages caused by "occur-rences" under Section I – Coverage A, and for all medical expenses caused by accidents under Section I – Coverage C, which cannot be at-tributed only to ongoing operations at a single designated construction project shown in the Schedule above:

1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products-completed Operations Aggregate Limit, whichever is applicable; and

2. Such payments shall not reduce any Desig-nated Construction Project General Aggre-gate Limit.

C. When coverage for liability arising out of the "products-completed operations hazard" is pro-vided, any payments for damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard" will reduce the Products-completed Operations Ag-gregate Limit, and not reduce the General Ag-gregate Limit nor the Designated Construction Project General Aggregate Limit.

D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, de- signs, specifications or timetables, the project will still be deemed to be the same construction project.

E. The provisions of Section III – Limits Of Insur-ance not otherwise modified by this endorsement shall continue to apply as stipulated.

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Policy # ENV56201795200

CAE 0131 Includes copyrighted material of Insurance Services Offices, Inc., with its permission. Page 1 of 2 1508 © 2015, SECURA INSURANCE, A Mutual Company

THIS ENDORSEMENT CHANGES YOUR POLICY. PLEASE READ IT CAREFULLY.

AUTO ADDITIONAL INSURED WRAP

This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement.

A. AUTOMATIC ADDITIONAL INSURED – PRIMARY AND NONCONTRIBUTORY

SECTION II – COVERED AUTOS LIABILITY COVERAGE, subsection A. Coverage, paragraph 1. Who Is An Insured is amended to add:

d. (1) Automatic Additional Insured – Primary And Noncontributory

Any person or organization is an additional insured when you and such person or organization have agreed in writing prior to a loss that such person or organization be added as additional insured on your policy. Such person or organization is an additional insured only with respect to liability for “bodily injury” or “property damage” resulting from the ownership, maintenance or use of a covered “auto”, provided the “bodily injury” or “property damage” is caused, in whole or in part, by you or by those acting on your behalf. This insurance is primary and is not contributing with any other insurance carried by the additional insured.

(2) Blanket Lessor Additional Insured Provisions

If the additional Insured is a lessor of a “leased auto”;

(a) Coverage

i. Any “leased auto” that is a covered “auto” will be considered a covered “auto” you own and not a covered “auto” you hire or borrow.

For a covered “auto” that is a “leased auto” Who Is An Insured is changed to include as an “Insured” the lessor.

ii. The coverages provided under this endorsement apply to any “leased auto” until the policy expiration date, or when the lessor or his or her agent takes possession of the “leased auto”, whichever occurs first.

(b) Loss Payable Clause

i. We will pay, as interest may appear, you and the lessor for “loss” to a “leased auto”.

ii. The insurance covers the interest of the lessor unless the “loss” results from fraudulent acts or omissions on your part.

iii. If we make any payment to the lessor, we will obtain his or her rights against any other party.

(c) The lessor is not liable for payment of your premiums.

(d) Additional Definition

As used in this endorsement:

“Leased auto” means an “auto” leased or rented to you including any substitute, replacement or extra “auto” needed to meet seasonal or other needs, under a leasing or rental agreement that required you to provide direct primary insurance for the lessor.

Policy #A3327931

CAE 0131 Includes copyrighted material of Insurance Services Offices, Inc., with its permission. Page 2 of 2 1508 © 2015, SECURA INSURANCE, A Mutual Company

B. WAIVER -- TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US

SECTION IV – BUSINESS AUTO CONDITIONS, subsection A. Loss Conditions, paragraph 5. Transfer Of Rights Of Recovery Against Others To Us is amended to add:

We waive any right of recovery we may have against any person or organization when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be waived from recovery because of payments we make for injury or damage arising out of an "accident" and resulting from the ownership, maintenance or use of a covered "auto". However, our rights may only be waived prior to the “accident” for which we make payment under this Coverage Part. The insured must do nothing after a loss to impair our rights.

File details come from the government source that posted it. Updated .