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Home My WebLink About109445 CONNELL RESOURCES INC - INSURANCE CERTIFICATE (11)rn—fii• led'17 CONRFI W ACORD,M CERTIFICATE OF LIABILITY INSURANCE 8/05,2009"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 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P O Box 270370 Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC # INSURED - INSURER A: Travelers Insurance Company ' Connell Resources, Inc. 7785 Highland Meadows Parkway Fort Collins, CO 80528 INSURER B: Pinnacol Assurance INSURERC: INSURER D: INSURER E: Ct7VFROGFS 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 DgTE (MM ED Y EFFTIYE POLICY MM DD EXPIRATION LIMITS A GENERAL LIABILITY DTC04794N532 06/01/09 06/01/10 EACH OCCURRENCE $1 00Q 000 X COMMERCIAL GENERAL LIABILITY DAMAGE O R TENTED $300 000 CLAIMS MADE 51OCCUR MED EXP (Any one person) $10 000 PERSONAL & ADV INJURY $1 000 000 X PC Ded:5,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 POLICY X JECOTII LOC A AUTOMOBILE LIABILITY. ANY AUTO DT8104794N532 06/01/09 06/01/10 COMBINED SINGLE LIMIT (Ea accident) $1,000000 r X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ I 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 $ AUTO ONLY: AGG A EXCESS/UMBRELLA LIABILITY DTSMCUP4794N532 06/01/09 06/01/10 EACH OCCURRENCE $10 000 000 _X1 OCCUR CLAIMS MADE AGGREGATE $10 000 000 $ DEDUCTIBLE $ X RETENTION $ 10 000 B WORKERS COMPENSATION AND 4029651 06/01/09 06/01/10 X WC STATUS FIR - EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEE.L. EACH ACCIDENT $SUU,000 E.L. DISEASE - EA EMPLOYEE s500,000 OFFICER/MEMBER EXCLUDED? NO If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT s500,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE: 7044 Misc Street Improvements The City, 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). A waiver of subrogation applies. City of Fort Collins Financial Services - Purchasing 215 N Mason St, 2nd Floor PO Box 580 Fort Collins, CO 80522 IIUN Tu uays Tor SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1t)_ 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 ACORD 25 (2001108) 1 of 2 #S470211/M447592 NIK 0 ACORD CORPORATION 1988 i 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 25-S (2001/08) 2 of 2 #S470211/M447592