HomeMy WebLinkAbout109445 CONNELL RESOURCES INC - INSURANCE CERTIFICATE (24)Cliant#: 14427
CONRE1
�ACORDTM CERTIFICATE OF LIABILITY INSURANCE
DATE
06101/04DmvY)
PRODUCER
Flood & Peterson Insurance Inc
4821 Wheaton Drive
P O Box 270370
Fort Collins, CO 80527
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
Connell Resources, Inc.
4305 E. Harmony Road
Fort Collins, CO 80528-9527
INSURERA: Zurich
INSURERB: American International Companies
INSURERC: Pinnacol Assurance
INSURER D:
INSURER E:
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.
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MWDD/YY
POLICY EXPIRATION
DATE MWDD/YY
LIMITS
A
GENERAL LIABILITY
CP0375782400
06/01/04
06/01/05
EACH OCCURRENCE
$1 000 000
COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED
$300OOO
CLAIMS MADE O OCCUR
MED EXP (Any one person)
$5 000
PERSONAL & ADV INJURY
$1 OQO Q00
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIM IT APPLIES PER:
PRODUCTS - COMP/OP AGG
$2000000
POLICY FX PEOT LOC
A
AUTOMOBILE
LIABILITY
ANY AUTO
CP0375782400
06/01/04
06/01/05
COMBINED SINGLE LIMIT
(Ea accident)
$1 rOOO ,000
X
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
X
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON-OWNEDAUTOS
X
X
PROPERTY DAMAGE
(Per accident)
$
Drive Other Car
ffl
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
B
EXCESS/UMBRELLA LIABILITY
-X1 OCCUR CLAIMS MADE
BE2681480
06/01/04
06/01/05
EACH OCCURRENCE
$3000000
AGGREGATE
s3,000,000
$
DEDUCTIBLE
$
X RETENTION $ 1 O 000
C
WORKERS COMPENSATION AND
4029651
06/01/04
06/01/05
X WC CRYSTATU- OTH-
ER
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
-
E.L.EACH ACCIDENT-
$50O 000
�
E.L. DISEASE - EA EMPLOYEd
$500,000
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
1 s500,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Re: CRI# 2031017 Misc. Patching Project #5516
Certificate holder is named as additional insured, but only as respects
liability arising out of work performed by the named insured (Excluding
Workers' Compensation).
City of Fort Collins
215 North Mason Street
PO Box 580
Fort Collins, CO 80522-0580
Iu-.cl
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3Q_ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABI F ANY "D UPON THE INSURER, ITS AGENTS OR
AUTHORIZED
AGVKU ZO (ZUUT/Ut$) 1 of 2 #M283554 NIK 0 ACORD CORPORATION 1988
Client#: 14427
CONREI
ACORDT. CERTIFICATE OF LIABILITY INSURANCE
DATE
06101/04D )
PRODUCER
Flood & Peterson Insurance Inc
4821 Wheaton Drive
P O Box 270370
Fort Collins, CO 80527
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
Connell Resources, Inc.
4305 E. Harmony Road
Fort Collins, CO 80528-9527
INSURERA: Zurich
INSURERB: American International Companies
INSURERC: Pinnacol Assurance
INSURER D:
INSURER E:
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.
INSR LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY
MWDDIYYEFFECTIVE
POLICY
DATE MWDDIYY EXPIRATION
LIMITS
A
GENERAL LIABILITY
CP0375782400
06/01/04
06/01/05
EACH OCCURRENCE
$1 00U 000
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE O OCCUR
DAMAGE TO RENTED
$300 UUU
MED EXP (Any one person)
$5 000
PERSONAL &ADV INJURY
$1 00U 000
GENERAL AGGREGATE
$2 00O OOO
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS-COMP/OP AGG
$2000000
POLICY X PRO LOC
JECT
A
AUTOMOBILE
LIABILITY
ANY AUTO
CP0375782400
06/01/04
06/01/05
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
X
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
X
X
PROPERTY DAMAGE
(Per accident)
$
Drive Other Car
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
B
EXCESS/UMBRELLA LIABILITY
BE2681480
06/01/04
06/01/05
EACH OCCURRENCE
s3,000,000
X OCCUR CLAIMS MADE
AGGREGATE
s3,000,000
$
DEDUCTIBLE
$
X RETENTION $ 1U 000
C
WORKERS COMPENSATION AND
4029651
06/01 /04
06/01/05
X I TNC ORYSTATUMIT- orH-
EIL
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE - EA EMPLOYEE
$500,000
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$500,000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
RE: CRI# 2041006 Northeast Area Overlay Project (Property at County Rd 11)
Certificate holder, Owner, Engineer, Engineer's Consultants are named as
additional insured, but only as respects liability arising out of work
performed by the named insured (Excluding Workers' Compensation).
City of Fort Collins
Purchasing Division
PO Box 580
Fort Collins, CO 80522-0580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 'An DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAIMQTO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR
AUTHORIZED
INSURER, ITS AGENTS OR
AGORD 25 (2001/05) 1 of 2 #M283554 NIK 0 ACORD CORPORATION 1988