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Home My WebLink About109445 CONNELL RESOURCES INC - INSURANCE CERTIFICATE (4)rhanH! 1AA77 ACORD- CERTIFICATE OF LIABILITY INSURANCE DATE(MMDD/YYYY) 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 P O Box 270370 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Fort Collins CO 80527 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA ZUFICh Connell Resources Inc INSURER American International Companies 4305E Harmony INSURERC Pinnacol Assurance FortCollins CO 60528 8527 INSURER D NSURER E MV 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 P ALICY EFFECTIVE POLATEICY M PIMTION LIMITS A GENERAL LIABILITY CP0375782404 06/01/07 06101/08 EACH OCCURRENCE $10000-0-0- X COMMERCIAL GENERALLMILITY CLAIMS MADE OCCUR DAMAGE TO RENTED MED EXP(Anyone person) f3000O0 $10000 X PERSONAL &ADV INJURY $1000000 PD Ded $5,000 GENERALAGGREGATE s2.000.000 GEN L AGGREGATE POLICY LIMIT APPLIES PER PRO LOC PRODUCTS COMP/OPAGG s2000000 A AUTOMOBILE X LIABILITY ANY AUTO CP0375782403 06/01/07 06/01/08 COMBINED SINGLE LIMIT (Ea acadent) E1 QOQ OOO ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY Per parson) f HIREDAUTOS X X NON OWNED AUTOS BODILY INJURY (Per awdent) E Drive Other Car X PROPERTY DAMAGE (Para dent) $ GARAGE LIABILITY AUTO ONLY EAACCIDENT $ OTHERTHAN EA ACC E ANY AUTO P $ AUTO ONLY AGG B EXCESSNMBRELLALIABILITY X OCCUR CLAIMS MADE BE7274938 06/01/07 06/01/08 EACH OCCURRENCE $5000000 AGGREGATE sj OOO OOO E DEDUCTIBLE X RETENTION $ 1 O 000 $ C EMPLOYERS LIABILITY WORKERS COMPENSATION AND 4029651 06/01/07 06/01/OB X WC STATU I OTH EL EACH ACCIDENT s500000 ANY PROPRIETORIPARTNEWEXECUTIVE OFFICERIMEMBER EXCLUDED? Hyyes describe under SPECIAL PROVISIONS below EL DISEASE EA EMPLOYEE $500000 EL DISEASE POLICY LIMIT $500000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE Asphalt Supply 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 Purchasing Division PO Box 580 Fort Collins CO 80522 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 NAMED TO THE LEFT BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR 25 (2001108) 1 of 2 #S405172/M388785 NBC a ACORD CORPORATinN IQRe IMPORTANT If the certificate holder is an ADDITIONAL INSURED the policy(ies) must be endorsed A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s) 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) DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s) authorized representative or producer and the certificate holder nor does it affirmatively or negatively amend extend or alter the coverage afforded by the policies listed thereon ^� �� ••��/ a OT L i 4ual lZ/Mjaalab