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Home My WebLink About109445 CONNELL RESOURCES INC - INSURANCE CERTIFICATE (14)Client#: 14427 CONREI ACORD- CERTIFICATE OF LIABILITY INSURANCE 4DATE /26/2/26/2M1DD/YYYY) 010 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE M DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS A GENERAL LIABILITY DTC04794N5321ND09 06/01/09 06/01/10 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 51OCCUR DAMAGE TO RENTEDPREMISES (E. occurrencel $300 000 MED EXP (Any one person) $10 000 PERSONAL & ADV INJURY $1 000 000 X PD Ded: $5,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 POLICY-X] PROECT LOC J A AUTOMOBILE LIABILITY ANY AUTO 8104794N532TIL09 06/01/09 06/01/10 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS X X PROPERTY DAMAGE (Per accident) $ Drive Other Car ri GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG A EXCESS/UMBRELLA LIABILITY X OCCUR CLAIMS MADE DTSMCUP4794N532TIL 06/01/09 06/01/10 EACH OCCURRENCE $10000000 AGGREGATE $1 O 00O 000 $ DEDUCTIBLE $ X RETENTION $ 10000 B WORKERS COMPENSATION AND 4029651-.06/01/09. 06/01/10 X WC STATU- OTH- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $500OOO E.L. DISEASE - EA EMPLOYEE $500OOO OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $500 000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE: 2101017 - 7120 College/Willox Roadway 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 1U SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL gyp_ 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 AUTHORIZED REPRESENTATIVE ACORD 25 (2001/08) 1 Of 2 #S524899/M478026 R "t 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. ACORD 25-S (2001/08) 2 of 2 #S524899%M478026 ;, .3 ;,. ; ,; •;h •,� t ., t ?4 ACORDTM CERTIFICATE OF LIABILITY INSURANCE 0DATE 5/29/2009Yrv> 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. 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. INSR LTR ADD NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDDIYY POLICY EXPIRATION DATE MMIDD Y LIMITS A GENERAL LIABILITY DTC04794N532- 06/01/09 06/01/10 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY IND09 DAMAGE TO RENTEDPREMISES (Ea oc urrence) $300OOO CLAIMS MADE a OCCUR MED EXP (Any one person) $1 O O00 PERSONAL & ADV INJURY $1 000 000 X PD Ded: $5,000 GENERAL AGGREGATE s2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 POLICY X PROECT LOC J A AUTOMOBILE LIABILITY DT8104794N532- 06/01/09 06/01/10 COMBINED SINGLE LIMIT X ANY AUTO TIL09 (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 Car M PROPERTY DAMAGE $ (Per accident) 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 $10000 000 X OCCUR CLAIMS MADE TIL09 AGGREGATE $10 00O 000 $ DEDUCTIBLE $ X RETENTION $ 1 O 000 B WORKERS COMPENSATION AND 4029651 06/01/09 06/01/10 X WC STATU- OTH- EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $500000 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 s500,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS RE: 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). A waiver of subrogation applies. CERTIFICATE HOLDER CANCELLATION 1U Da s for Non -Pa ment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Fort Collins DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3_ DAYS WRITTEN Purchasing Division NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL PO Box 580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Fort Collins, CO 80522 REPRESENTATIVES. REPRESENTATIVE ACORD 25 (2001/08) 1 Of 2 #S446355/M446343 NIK O ACORD CORPORATION 1988 RF001:A EA i 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. AGUKo 25-5 (zooiiUs) 2 of 2 #S4463551M446343