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HomeMy WebLinkAbout109445 CONNELL RESOURCES INC - INSURANCE CERTIFICATE (6)ACORD- CERTIFICATE OF LIABILITY INSURANCE U;29/ 8Dwy" 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 Zurich Connell Resources Inc INSURER B American International Companies 7785 Highland Meadows Pkwy INSURER PlnnacolAssurance Windsor CO 80528 INSURER D INSURER E 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 INSR TYPE OF INSURANCE POLICY NUMBER DA7EY E E POLICYEXPIRATION DATE LIMITS A GENERAL LIABILITY CP0375782405 06/01/08 06/01/09 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 51OCCUR DAMAGE TO RENTED $300OOO MED EXP(Arty one parrs) $10000 X PD Ded 5,000 PERSONAL & ADV INJURY $1 000.000 GENERAL AGGREGATE s2,000,000 GEN L AGGREGATE LIMIT APPLIES PER POLICY X PRO LOC JECT PRODUCTS COMPIOPAGG $2000000 A AUTOMOBILE X LIABILITY ANY AUTO CP0375782404 06/01/08 06/01/09 COMBINED SINGLE LIMIT (Ea amident) $1 000 000 ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ HIRED AUTOS X NON -OWNED AUTOS BODILY INJURY (Per amdent) E X Drive Other Car X PROPERTY DAMAGE (Per amdent) $ GARAGE LIABILITY AUTOONLV EAACCIDENT $ ANY AUTO OTHER THAN FA ACC $ $ AUTO ONLY AGO B EXCESSIUMBRELLALIABILITY X OCCUR CLAIMS MADE BE7275064 06/01/08 06/01/09 EACH OCCURRENCE $5000000 AGGREGATE $5 000 000 S DEDUCTIBLE RETENTION $ 1 OOOO X E C WORKERS COMPENSATION AND EMPLOYERS LIABILITY 4029651 06/01/08 06/01/09 X WCSTATU OTH E L EACH ACCIDENT $500000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? H yyea AL IR a antler I'M "LPROVISIONSbelow E L DISEASE EA EMPLOYEE $500000 EL DISEASE POLICY LIMIT s5000OO OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE CRI# 2071031 5858 Miscellaneous Street Improvements Certificate holder Is named as additional insured but only as respects liability arising out of work performed by the named Insured (Excluding Workers Compensation) / =MO IVI^AT� - - City of Fort Collins 215 N Mason St PO Box 580 Fort Collins CO 80522-0580 LID ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL -3Q_ 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 #M416619 NIK 0 ACORD CORPORATION 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 ACORD 25S (2001/081 9 . f 7 NUA4&04e ACORD- CERTIFICATE OF LIABILITY INSURANCE o5;Z9/ 8°"Y""' PRODUCER Flood & Peterson Insurance Inc 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 4821 Wheaton Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW P O Box 270370 Fort Collins CO 80527 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA Zurich Connell Resources Inc 7785 Highland Meadows Pkwy Windsor CO 80528 INSURER American International Companies INSURER C Pinnacol Assurance INSURER 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 INSIR LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE IMF DM CTIVEPDAITYEXPI OTK)N LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FX] OCCUR X PD Ded 5,000 CP0375782405 06/01/08 06/01/09 EACH OCCURRENCE $1 000 000 DAMAGE TO RENTED $300 OOO MED EXP (Any one person) $1 O 000 PERSONAL B ADV INJURY $1 000 000 GENERAL AGGREGATE s2,000,000 GEN L AGGREGATE LIMIT APPLIES PER POLICY F X PRO- LOC PRODUCTS COMPIOPAGG $2000000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON OWNED AUTOS Drive Other Car CP0375782404 06/01/08 06/01/09 COMBINED SINGLE LIMIT (Ea amtlenp $1000000 X BODILY INJURY (Per person) $ X BODILY INJURY (Per acudent) $ X X PROPERTY DAMAGE (Per amdeni) $ GARAGE LIABILITY ANY AUTO AUTOONLY EAACCIDENT $ OTHERTHAN EA ACC AUTO ONLY AGG $ $ B EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ 10000 BE7275064 06/01/08 06/01/09 EACH OCCURRENCE $5 000 000 X AGGREGATE $5 00O 000 $ X $ C WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED+ If yes 4esmbe under SPECIAL PROVISIONS below 4029651 06/01/08 06/01/09 TH X WCSLIMTATU OER E L EACH ACCIDENT $500000 E L DISEASE EA EMPLOYEE $500000 E L DISEASE POLICY LIMIT $500000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE CRI# 2061010 Timberline Road Widening Project 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 N Mason St 2nd Floor Fort Collins CO 80522 LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF THE ISSUING INSURER WILL KII099 MMAIL A0_ DAYS WRITTEN CERTIFICATE HOLDER NAMED TO THE LEFT ACORD 25 (20011091 4 . f 9 1HUI AR4T. MIK 199E 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 endorsements) 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 ^—�^-• --- '.,.,. ^..i c or c smaiooJa ACORD- CERTIFICATE OF LIABILITY INSURANCE 05129,8°""YY' 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 9 INSURED ConINSURERA Resources Zurich INSURER B American International Companies 7785 Highland 785 Highland Meadows Pkwy INSURER C Pinnacol Assurance Windsor CO 80528 INSURER D INSURER E 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 IN TYPE OF INSURANCE POLICY NUMBER DATE (MM CTW DA Y DDNY N LIMITS A GENERAL LIABILITY CP0375782405 06/01/08 06/01/09 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE Fx� OCCUR DAMAGE TO RENTED $30U QQQ $1 Q 000 MED EXP (Any one Person) X PD Ded 5,000 PERSONAL &ADV INJURY $1 QQQ QQQ GENERAL AGGREGATE s2,000,000 GEN L AGGREGATE LIMIT APPLIES PER POLICY X PRO LOC PRODUCTS COMP/OP AGG $2 QQQ QQQ A AUTOMOBILE X UMBILITY ANY AUTO CP0375782404 06/01/08 06/01/09 COMBINED SINGLE LIMIT (Ea aoddent) $1 QQQ QQQ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per perm) $ HIRED AUTOS NON -OWNED AUTOS X DIY (Perr aoddenRY) $ X Drive Other Car X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTOONLY EAACCIDENT $ OTHER THAN FA ACC AUTO ONLY AGO $ ANY AUTO $ B EXCESSIUMBRELLA LIABILITY X OCCUR CLAIMS MADE BE7275064 06/01/08 06/01/09 EACH OCCURRENCE $5 000 000 AGGREGATE s5,000,000 $ DEDUCTIBLE X RETENTION $ 10000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 4029651 06/01/08 06/01/09 X WO0RYUu OFT E L EACH ACCIDENT $500 OOO ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED?E I(yes ALd.PRO under SPECIAL PROVISIONS bebr L DISEASE EA EMPLOYEE $500 000 EL DISEASE POLICY LIMIT $500 000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE 2007 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 215 N Mason Street 2nd Floor Fort Collins CO 80522 I ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION IEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL An DAYS WRITTEN TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SO SHALL NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR ACORD 25 (2001/08) 1 of 2 #M416619 NIK 0 ACORD 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 endorsements) 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 ACORD 25S (2001/081 9 of 9 wwneenn