The URL can be used to link to this page

Home My WebLink About109445 CONNELL RESOURCES INC - INSURANCE CERTIFICATE (12)ACORD- CERTIFIGA E-"OF LIABILITY INSURANCE 7DATE (MMIDD /13/2009mrr) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION i=lood 8r 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. INSURER B: Pinnacol Assurance 7785 Highland Meadows Parkway INSURER C: Fort Collins, CO 80528 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. INS LTR INSRN TYPE OF INSURANCE:�:= POLICY NUMBER POLICY EFFECTIVE DATEJMMIDDIYYI POLICY EXPIRATION DATE MM DD LIMITS A GENERAL LIABILITY DTC04794N532 06/01/09 06/01/10 EACH OCCURRENCE $1 OOOOOO X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES (Ea occ rrencel $300000 MED EXP (Any one person) $1 O 000 CLAIMS MADE Q OCCUR PERSONAL & ADV INJURY $1 000 000 X PD Ded:5,000 P GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 POLICY X PR,C oi LOC A AUTOMOBILE LIABILITY X ANY AUTO DT8104794N532 06/01/09 06/01/10 COMBINED SINGLE LIMIT (Ea accident) $1000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X HIRED AUTOS X NON -OWNED AUTOS BODILY INJURY (Per accident) $ X Drive Other Car PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO E $ AUTO ONLY: AGG A EXCESS/UMBRELLA LIABILITY X OCCUR CLAIMS MADE DTSMCUP4794N532 06/01/09 06/01/10 EACH OCCURRENCE $10000 000 AGGREGATE $1 O OOO 000 $ DEDUCTIBLE $ X RETENTION $ 1 O 000 B WORKERS COMPENSATION AND 4029651 06/01/09 06/01/10 X WC STATU- DER EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT. $500 000 E.L. DISEASE - EA EMPLOYEE $500,000 OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below NO E.L. DISEASE - POLICY LIMIT s500,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE: CRI #2091520 - Renewal, 6113 Snow and Ice Removal. City of Fort Collins 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 c/o John Stephen - Purchasing Division 215 N. Mason, 2nd Floor PO Box 580 Fort Collins, CO 80522 SHOULD ANY 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 TIVE ACORD 25 (2001/08) 1 of 2 #S459117/M447592 DXS 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. ACORD 25S (2001/08) 2 of 2 #S459117/M447592 ACORD- CERTIFICATE OF LIABILITY INSURANCE 7DATE /13/2009�YYY) 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 Connell Resources, Inc. 7785 Highland Meadows Parkway Fort Collins, CO 80528 INSURER A: Travelers Insurance Company INSURER B: Pinnacol Assurance INSURER C: 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. IN R LTR ADD' NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS A GENERAL LIABILITY DTC04794N532 06/01/09 06/01110 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $300000 CLAIMS MADE Fx� OCCUR MED EXP (Any one person) $1 O 000 PERSONAL & ADV INJURY $1 00O 000 X PD Ded:5,000 GENERAL AGGREGATE [PRODUCTS s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: - COMP/OP AGG s2,000,000 POLICY-X] JECOT LOC A AUTOMOBILE LIABILITY DT8104794N532 06/01/09 06/01/10 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $1,000,000 BODILY INJURY $ ALL OWNED AUTOS SCHEDULED AUTOS (Per person) BODILY INJURY $ X HIRED AUTOS X NON -OWNED AUTOS (Per accident) Drive Other CarPROPERTY M DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG A EXCESSIUMBRELLA LIABILITY DTSMCUP4794N532 06/01/09 06/01/10 EACH OCCURRENCE $10000 000 X OCCUR 7 CLAIMS MADE AGGREGATE $10 000 000 $ DEDUCTIBLE $ X RETENTION $ 10 000 B WORKERS COMPENSATION_ AND 4029651 06/01/09 06/01/10 X WC STATU- OTH- ORY LIMITS EMPLOYERS' LIABILITY _ _ _ E.L. EACH ACCIDENT $500OOO ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYEE $500OOO OFFICER/MEMBER EXCLUDED? NO If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS RE: CRI #2091520 - Renewal, 6113 Snow and Ice Removal. City of Fort Collins 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 c/o John Stephen - Purchasing Division 215 N. Mason, 2nd Floor PO Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL '10 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 REPRESENTATIVES. REPRESENTATIVE ACORD 25 (2001/08) 1 Of 2 #S459117/M447592 DXS 0 ACORD CORPORATION 1988