HomeMy WebLinkAbout109445 CONNELL RESOURCES INC - INSURANCE CERTIFICATE (10)ACORDn, CERTIFICATE OF LIABILITY INSURANCE
YYY)
OS/29/2OO9
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
NAIL #
INSURED
Connell Resources, Inc.
7785 Highland Meadows Parkway
Fort Collins, CO 80528
INSURER A: Travelers Insurance Company
_
INSURER PinnacolAssurance
INSURERC:
-
—
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.
NS
LTR
DO'
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMIDDIYY
POLICY EXPIRATION
DATE MM DD/YV
LIMITS
A
GENERAL LIABILITY
DTC04794N532-
06/01/09
06/01/10
EACH OCCURRENCE
$1
X COMMERCIAL GENERAL LIABILITY
IND09
DAMAGE TO RENTED
_000000
5300000
MED EXP(Any one person)
$10000
CLAIMS MADE aOCCUR
PERSONAL &ADV INJURY
$1000000
X PD Ded:$5,000
GENERALAGGREGATE
s2,000.000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGO
$2000000
POLICY PRO-
ECT OC X
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
DT8104794N532-
TIL09
06/01/09
06/01/10
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
X
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
X
X
Drive Other Car
PROPERTY DAMAGE
(Per accitlent
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGO
A
EXCESSIUMBRELLA LIABILITY
X OCCUR 1:1CLAIMS MADE
DTSMCUP4794N532-
TIL09
06/01/09
06/01/10
EACH OCCURRENCE
$10 000 000
AGGREGATE
$10000 000
DEDUCTIBLE
$
X RETENTION $ 1 O 000
B
WORKERS COMPENSATION AND
4029651
06/01/09
06/01/10
X WC STATU-
EMPLOYERS'LIABILITY
ANY PROPRIETOR/PARTNER/EXEC ITIVE
E.L. EACH ACCIDENT
$500 OOO
E.L. DISEASE - EA EMPLOYEE
$SOD OOO
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
S
NO
C.L. DISEASE -POLICY LIMIT
$500,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
RE: CRI #2081047 - Robert Benson Reservoir Dam Improvements
City of Fort Collins & Anderson Consulting Engineers, Inc. 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 Street, 2nd Floor
Fort Collins, CO
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _30_ 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
REPRESENTATIVE
AI Ltmu LB (LUullua) 1 Ot 2 #5446353/M446343 NIK 0 ACORD CORPORATION 1988
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.
AUVKU Zp•5 (ZVU"IWO) 2 of 2 #S446353/M446343