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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