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Home My WebLink About109445 CONNELL RESOURCES INC - INSURANCE CERTIFICATE (5)ACORDa CERTIFICATE OF LIABILITY INSURANCE osi29i a°""""' 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 P O Box 270370 HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Fort Collins CO 80527 INSURERS AFFORDING COVERAGE NAIC # INSURED Connell Resources Inc 7785 Highland Meadows Pkwy Windsor CO 80528 INSURERA Zurich INSURER B American International Companies INSURER C 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 NS TYPE OF INSURANCE POLICY NUMBER LICYM FFEC POLICY EXPIRATIONDATE LIMITS A GENERAL LIABILITY CP0375782405 06/01/08 06/01/09 EACH OCCURRENCE $1 000000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FX-1 OCCUR DAMAGE TO RENTEDPREMISES IF, E300OOO MED EXP (Any one Person) $1 O 000 PERSONAL &ADV INJURY $1 OOO 000 X PO Ded 5,000 GENERAL AGGREGATE s2,000,000 GEN L AGGREGATE LIMIT APPLIES PER PRODUCTS COMPIOPAGG s2000000 POLICY X PEOT LOC A AUTOMOBILE LIABILITY ANY AUTO CP0375782404 06/01/08 06/01/09 COMBINED SINGLE LIMIT (Ea accident) $r000 1 OOO X BODILY INJURY (Par Parson) $ ALL OWNED AUTOS SCHEDULED AUTOS X X HIREDAUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ Drive Other Car X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTOONLY EAACCIDENT $ OTHER THAN FA ACC $ ANY AUTO $ AUTO ONLY AGG B EXCESWUMBRELLA X LIABILITY OCCUR CLAIMS MADE BE7275064 06/01/08 06/01/09 EACH OCCURRENCE $5000000 AGGREGATE s5,000,000 $ DEDUCTIBLE X $ RETENTION $ 10000 C WORKERS COMPENSATION AND 4029651 06/01/08 06/01/09 OTH X I TWORIKUNTS EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE EL CHACCIDENT $SOO OOO EL DISEASE FAEMPLOYEE $500000 OFFICER/MEMBER EXCLUDED? If yes desanbeunder SPECIAL PROVISIONS below EL DISEASE POLICY LIMIT 1$500,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE Asphalt Supply 6045 Certificate holder is named as additional insured but only as respects liability arising out of work performed by the named Insured (Excluding Workers Compensation) A waiver of subrogation applies City of Fort Collins Purchasing Division PO Box 580 Fort Collins CO 80522 ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SO SHALL IE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR ACORD 25 (2001/08) 1 of 2 SMA1 RA14 mow n ArnOn rnODnDATInM 4000 CERTIFICATE HOLDER COPY City of Fort Collins Attn John 300 Laporte Avenue Fort Collins CO 80522 IMPORTANT If the certificate holder is an ADDITIONAL INSURED the pollcy(les) 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