HomeMy WebLinkAbout109445 CONNELL RESOURCES INC - INSURANCE CERTIFICATE (25)ACORD- CERTIFICATE OF LIABILITY INSURANCE 6/23ioa°°"""'
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
4821 Wheaton Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P O Box 270370
Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC q
INSURED INSURERA: Zurich
Connell Resources, Inc. INSURERB: American International Companies
4305 E. Harmony Road INSURERC: Pinnacol Assurance
Fort Collins, CO 80528-9527 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 MWDDIYY
POLICY EXPIRATION
DATE MWDDIYY
LIMITS
A
GENERAL LIABILITY
CON3757824
06/01/04
06/01/05
EACH OCCURRENCE
$1 000000
DAMAGE TO R(EaENTE0cuDPRE ES
S300OOO
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE a OCCUR
MED EXP (Any one person)
$5 000
PERSONAL &ADV INJURY
$1 00O 000
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGG
$2 00U 000
POLICY X PRCTO LOC
JE
A
AUTOMOBILE
LIABILITY
ANY AUTO
CON3757824
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
$
AUTOONLY: AGG
B
EXCESS/UMBRELLA LIABILITY
BE2681480
06/01/04
06/01/05
EACH OCCURRENCE
$2 OOO O00
X1 OCCUR CLAIMS MADE
AGGREGATE
s2,000,000
$
RDEDUCTIBLE
$
X RETENTION $ 10,000
C
WORKERS COMPENSATION AND
4029651
06/01/04
06/01/05
X WC STATTORLIMITU- OTH-
EjL
EMPLOYERS' LIABILITY
ANY PFtOPRIETORlPARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE - EA EMPLOYEd
$500,000
OFFICER/MEMBER EXCLUDED?
l yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE- POLICY LIMIT
1 s500,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Re: CRI# 2041030 - Bid# 5858 Misc. Street Improvements
City of Fort Collins, its officers, agents and employees 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
215 N Mason St, 2nd Floor
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 20_ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBILIGAIION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
ACORD 25 (2001108) 1 of 2 #S285853/M283570
TION 1988