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Home My WebLink About109445 CONNELL RESOURCES INC - INSURANCE CERTIFICATE (15)Client#: 14427 CONREI ACORD. CERTIFICATE OF LIABILITY INSURANCE °o� /201° THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. 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 endorsemengs). PRODUCER Flood & Paterson Ins., Inc. P. O. Box 578 Greeley, CO 80632 970356-0123 CONTACT NONE, Nikki Mosbrucker PHONE 970-266-7123 970-506-6823 No Ex: A/C, No: - ?D61NRES:Iikki.mosbrucker@tpinsurance.com PRUDUUEHFTC full cert CUSTOMER ID I: INSURER(S) AFFORDING COVERAGE NAIC# INSURED INSURER A: Travelers Insurance Company Connell Resources, Inc. 7785 Highland Meadows Parkway Fort Collins, CO 80528 INSURER B: Pinnacol Assurance INSURER C INSURER 0: ' INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE SR WD POUCYNUMBEfl POLICY EFF MMtD POLICY UP MMTI LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE �X OCCUR DTC04794N532- IND11 6/01=11 06/01/2012 EACHOGCURRENCE $1000000 PREMISES Ea cocurrence $300000 MEDEXP(Anyonepewn) $10000 PERSONAL&ADV INJURY $1 OOOOOO GENERALAGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POUCV X PRO LOC PRODUCTS - COMP/OP AGO $2,000,000 $ A AUTOMOBILE LIABILITY ANYAUTO ALLOWNEDAUTOS SCHEDULED AUTOS HIRED AUTOS AUTOS Drive Other Car DT8104794N532- TIL71 6/01/2011 06/01/2012 COMBINED SINGLE UMIT (Ea accident)$1 OOOOOO BODILY INJURY(Per person) $ BODILY INJURY(Per accident) $ 1XXX PROPERTY DAMAGE (Peraccident)NON-OWNED $ $ A X UMBRELLA LIAR EXCESS LAB i x OCCUR CLAIMS -MADE DTSMCUP4794- N532TILl1 6/01/2011 06/01/2012 EACH OCCURRENCE $10000000 AGGREGATE $10OOO 000 DEDUCIBLE RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS LIABILITY IN ANY PROPRIETOWPARTNEIVEXECUITVEY OFFICERIMEMBER EXCLUDED? n (Mandatory In NH) If yyes, rta eunder DESCRIPDON OF OPERATIONS below NIA 4029651 6/01/2011 06/01/201 X WC STATU- OTH- E.L EACH ACCIDENT $500000 E.L. DISEASE - EA EMPLOYEE $500,000 E.L. DISEASE - POLICY LIMIT J$500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Aftch ACORD 101, Addlllonal flemarb Schedule, N more space Is required) RE: 2111008; Fossil Creek Trail Extension & Underpass at County Road 38E. Certificate holder is included as Additional Insured as required by written contract with respects to liability arising out of work performed by the named insured. Waiver of Subrogation applies. City of Fort Collins PO Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2009/09) 1 of 1 #S615946/M615935 01988.2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NI Client#: 14427 CONREI ACORD CERTIFICATE OF LIABILITY INSURANCE DATE""' O5/26/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED . REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: R the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. 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 endomement(s). PRODUCER Flood & Peterson Ins., Inc. P. O. Box 578 Greeley, CO 80632 970 35"123 CONTACT NAME, Nikki Mosbrucker vxoNE 970-266-7123 970.508-6823 ESt : (A/C No 9::iikki.mosbrucker@fpinsurance.com ADDRESS: nikki.mosbrucker®fpinsurance.com FRUOUGERcent [DO: FTC full ce 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 INSURER C INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE SR a POLICY NUMBER POLICY EFF MMID POUCYEXP MMID LIMITS A GENERAL LIABILITY X COMMERCIAL GENERALUABILJTV CLAIMS -MADE 7XI OCCUR DTC04794N532- IND71 6/01/2011 06/01/201 EACH OCCURRENCE $1 00O OOO VAMAU�UH PREMISES Eaaccunenca E300000 MEDEXP(Anyons Person) $10000 PERSONAL& ADV INJURY $1 000 000 GENERALAGGREGATE s2,000,000 GEN'L AGGREGATE POUCV LIMIT APPLIES PER: X PRO- LOC IFCTA PRODUCTS - COMP/OP AGO s2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS Drive Other Car DT8104794N532- TIL11 6/01/2011 06/01/2012 COMBINED ) INGLE UMTT $1,000,000 X BODILY INJURY (Per Person) $ BODILY INJURY (Per eooident) $ PROPERTY DAMAGE (Peramident) $ X X X $ $ A X UMBRELLA LIAB EXCESS LIAe % OCCUR CIAIMS-MADE I DTSMCUP4794- N532TIL11 I 6/01/2011 06/01/201 EACH OCCURRENCE $10000000 AGGREGATE $10ODD 000 DEDUCTIBLE RETENTION S S S B WORRIERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE—I OFFICERWEMBER EXCLUDED? i ni (MendrtOry In NIQ B yeS, deecdba under DESCRIPTION OF OPERATIONS bebvi N/A 4029651 6/01/2011 06/0112012 X I WC STATU- OTH- E.L EACH ACCIDENT $500000 E.L DISEASE - EA EMPLOYEE S500 000 E.L DISEASE - POLICY LIMIT E500000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD IM, Ad Mons) Remarks SchedW& N reps space Is requlreci) RE: CRI# 2101054 - CR 54G Waterline 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. A waiver of subrogation applies. City of Fort Collins PO Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD NCRt S4A6/MW1R9g.9 NIK Client#: 14427 CONREI ACORN, CERTIFICATE OF LIABILITY INSURANCE D TE" ;YY' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: H the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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). PRODUCER Flood & Peterson Ins., Inc. P. O. Box 578 Greeley, CO 80632 970 356-0123 CONTACT NAME; Nikki Mosbrucker , 970-266-7123 No: 970-506-6823 ,' PAAME:REss: n ADOikki.mosbrucker@tpinsurence.com CUSTOMER ID FTC full Cart II: INSURERS AFFORDING COVERAGE NAIC If INSURED Connell Resources, Inc. 7785 Highland Meadows Parkway Fort Collins, CO 80526 INSURER A: Travelers Insurance Company ------ INSURERS: PInnaC01 Assurance INSURER C INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LM TYPE OF INSURANCE ML POLICY NUMBER MWDDfYYF MWDYEXP UMMS A GENERAL LIABILITY X COMMERCIAL GENERAL UABIUTY CLAIMS -MADE 516CCUR DTC04794N532- IND11 6/01/2011 06/01/2012 EACH OCCURRENCE $1 OOOOOo PREMISES Edoccuneme s3000OO MEDEXP(Anyonepermn) $10000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE S2 000,000 GENL AGGREGATE POLICY UMRAPPUES PER: X PRP LOC PRODUCTS - COMP/OP AGO s2,000,000 $ A AUTOMOBILE LIABILITY ANYAUTO AU-OWNEDAUTOS SCHEDULED AUTOS HIRED AUTOS AUTOS Drive Other Car DT8104794N532- TIL11 I 6/01/2011 06/D112012 COMBINED SINGLE LIMIT (Ea amident) $1000000 BODILY INJURY(Per Person) $ BODILY INJURY(Per accdent) $ 1XXX PROPERTY DAMAGE (Par accident)NON-OWNED $ S A X UMBRELLA LIAR EXCESS LIAR % OCCUR OLAIMS-MADE DTSMCUP4794- N532TIL11 - 6/01/2011 06/01/201 EACH OCCURRENCE $1000O 000 AGGREGATE $10000000 DEDUCTIBLE RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' UABILRYER ANY PROPRIETORIPARTMER/EXECUDV YIN OFFICER/MEMBER EXCLUDED? (MIf yyandaton, In NH) 0 SCscribe under RIPIN OF OPERATIONS below N/A 4029651 6/01/2011 06/01/2012 X WCSTATT} OTH- E.L EACH ACCIDENT $500000 E.L DISEASE - EA EMPLOYEE $500000 E.L DISEASE- POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ANech ACORD 101, Addhionel Remade, Schedule, N mare space Is mquInNI) RE: CRI# 2101003 - RFP 7089: Water Wastewater & Stormwater Utility Certificate holder is named as additional insured, but only as respects liability arising out of work performed by the named insured (Excluding Workers' Compensation). A waiver of subrogation applies. City of Fort Collins Purchasing Division PO Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2009/09) 1 of 1 ##S615949/M615935 01988.2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NIK Client#: 14427 CONREI ACORD. CERTIFICATE OF LIABILITY INSURANCE osnsnoll D05,12ATE 6DD111 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: N the certificate holder is an ADDITIONAL INSURED, the polley(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain pollcies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Flood & Peterson Ins., Inc. P. O. Box 578 Greeley, CO 80632 970356-0123 CONTACT NAME, Nikki Mosbrucker PHONE 970-266-7123 970-506-6823 ArC No EH: A/C No: ADOREss: nikki.mosbrucker®fpinsurance.com CUSTOMER ID e: FTC full cart INSURER(S) AFFORDING COVERAGE NAICI INSURED INSURER A: Travelers Insurance Company Connell Resources, Inc. 7785 Highland Meadows Parkway Fort Collins, CO 80528 INSURER B: Pinnacol Assurance INSURER C: _ INSURER D INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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 MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY NUMBER POLICY EFF MM/DDIYYYY) POLICY EXP (MMI'll LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX1OCCUR DTC04794N632- IND11 I 6/01/2011 06/01/2012 EACH OCCURRENCE $1000000 PREMISES Memcurrenca s3000OO MED EXP(My one Person) $10,000 PERSONAL&ADVIMURY $1000000 GENERALAGGREGATE s2,000,000 GENL AGGREGATE LIMIT APPLIES PER: POLICY X JECTPRO LOC PRODUCTS - COMP/OP AGO $2000000 I $ A AUTOMOBILE UABILMY ANVAUTO ALLOWNEDAUTOS SCHEDULED ALTOS HIRED AUTOS AUTOS Drive Other Car DT8104794N532- TIL71 6/01/2011 -BODILY 06/01/2012 COMBINED SINGLE LIMIT (Ea accident) $1000000 BODILY INIURY(Per person) $ 1XXX INIURY(Per accident) $ PROPERTY DAMAGE (Foretold nI)NON-OWNED $ $ A UMBRELLA LIAB EXCESS DAB X OCCUR CLAIMS -MADE DTSMCUP4794- N532TIL11 6/01/2011 06/0112012 EACH OCCURRENCE $10 000 000 AGGREGATE $10000 000 DEDUCTIBLE RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITYER ANY PROPRIETOR/PARrNERrEXECUTVEY OFFICERIMEMBER EXCLUDED? n (Mendetory In NH) It yes, describe under OE SCRIPTION OF OPERATIONS below WA 4029651 6/01/2011 06/01/201 X WC STATULIN OTH- E.L EACH ACCIDENT s500 OOO E.L DISEASE - EA EMPLOYEE s500,000 E.L DISEASE - POLICY LIMIT $500000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ALLech ACORD 101, Additional Remerks Schedule, N mom apace V requlred) RE: Asphalt Supply Certificate holder is named as additional insured, but only as respects (See Attached Descriptions) City of Fort Collins Purchasing Division PO Box 680 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POUCHES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ACORD 25 (2009109) 1 of 2 #S615947/M615935 01988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NIK Client#: 14427 CONREI ACORD. CERTIFICATE OF LIABILITY INSURANCE °o� /201°11 "' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the polky(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terns and conditions of the policy, certain policies may require an endorsement. A statement an this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Flood & Peterson lns.,Inc. P. O. Box 578 Greeley, CO 80632 970356-0123 CONTACT NONE; Nikki Mosbrucker PnoNE 970-266-7123 970-506-6823 A/C No EXI: AA:, No: ADDRESS: nikki.mosbrucker@fpinsurance.com PRODUCER FTC full cert CUSTOMER ID If: INSURERS AFFORDING COVERAGE NAICa INSURED INSURER A: Travelers Insurance Company Connell Resources, Inc. 7785 Highland Meadows Parkway Fort Collins, CO 80528 INSURER B:PinnacolAssurance INSURER C: INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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 MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE kDDL3UBRPOLICY POLICY NUMBER EFF MM/D POLICY EXP MMA) LIMITS A GENERALLIABILRY X COMMERCIAL GENERALLIABILTY CLAIMS -MADE 17X OCCUR DTC04794N532_ IND11 6/01/2011 06/01/2012 EACH OCCURRENCE $1000000 WMIT -- PREMISES Ea occurrence $300000 MED EXP(Any one person) $10,000 PERSONAL B ADV IWURY $1,000,000 GENERALAGGREGATE $2,000,000 GEN'L AGGREGATE 17 POLICY UMIT APPLIES PER: X PRP LOC PRODUCTS - COMP/OP AGG $2 000 000 $ A AUTOMOBILE LIABILITY ANY AUTO AU-OWNEDAUTOS SCHEDULED AUTOS HIRED AUTOS NON-0WNEDAUTOS Drive Other Car DT8104794N532- TIL11 6/01/2011 06MJ/2012 COMBINED SINGLE LIMIT (Ea axident) $1000000 X BODILY INJURY (Per parson) $ BODILY IWURY(Per accident) $ PROPERTY DAMAGE (Per=ident) $ X X X $ $ A X UMBRELLA LIAB EXCESS LIAR X OCCUR CLAIMS -MADE DTSMCUP4794- N532TIL11 6/01/2011 06101/201 EACH OCCURRENCE $10000000 AGGREGATE $10 DOD 000 D RETENTIONEDUCi1BLE $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITYS ANY PROPRIETOR/PARTNER/EXECUNVEY@ OFFICEWMEMBER EXCLUDED? n (Mandatory In NH) If yes, desnriW Under DESCRIPTION OF OPERATIONS bd. WA 4029651 6/01/2011 O6/01/201 X TW,IMIT oTH- PH E.L EACH ACCIDENT s5000OO E.L. DISEASE - EA EMPLOYEE s500,000 E.L. DISEASE -POUCY LIMIT $5000OO DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (AMeh ACORD 101, Addrdoml Remarks Sehedul% H mare space Is reAulred) RE: CRI# 2111003 DTRD Linden Street Utilities Improvement W.O. #SC-DTRD-01-18-2011 The City, its officers, agents and employees; and CDOT are named as additional insured, but only as (See Attached Descriptions) City of Fort Collins 700 Wood St Fort Collins, CO 80521 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 Ot 2 The ACORD name and logo are registered marks of ACORD #SB1594 /MB1 9 NIK Client#: 14427 CONREi ACORD.. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 06/26/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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). PRODUCER Flood &Peterson Ins., Inc. Box G ley, CO 80632 Greeley, 970 356-0123 CONTACT NAME: Nlkkl MOSbr[lCker a/c °No Ezt , 970-266-7123 A/C No , 970-506-6823 AODRESs: nikki.mosbruckerOfpinsurance.com CUSTOMER lD#: FTC full Cert INSURER(S) AFFORDING COVERAGE NAIC # INSURED Connell Resources, Inc. 7786 Highland Meadows Parkway Fort Collins, CO 80528 INSURER A: Travelers Insurance Company INSURERB: Pinnacol Assurance INSURER C : INSURER D : INSURER E: ENSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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 PERTAM, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY NUMBER MWDDIYFF XP POLICY YY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR DTC04794N532- 1ND11 6/01/2011 06/01/2012 EACH OCCURRENCE $1 000000 DAMAGE TO RENTE15— PREMISES Ea occurrence 1300,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GE N'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO LOG PRODUCTS - COMP/OP AGG $2,000,000 $ A AUTOMOBILE LIABILITY ANYAUTO ALL, OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS Drive Other Car DT8104794N532- TIL11 6/01/2011 06/01/2012 COMBINED SINGLE LIMIT (Ea accident) $1 000 000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ X X1 $ $ A X UMBRELLA LIAB EXCESS LIAB x OCCUR CLAIMS -MADE DTSMCUP4794- N532TIL11 6/01/2011 06/01/2012 EACH OCCURRENCE $10 000 000 AGGREGATE $10 000 000 DEDUCTIBLE RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / NLIMIS ANY PROPRIETORIPARTNEWEXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If ESCyes, describe underOPERATIONS below DRIPTION OF WA 4029651 6/01/2011 06/01/201 X WC STATU• OTH- ER E.L. EACH ACCIDENT $500OOO E.L. DISEASE • EA EMPLOYEE $500,000 E.L. DISEASE - POLICY LIMIT $500 000 DESCRIPTION OF OPERATIONS / LOCATIONS! VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It more space Is required) RE: CRI# 2101049 - 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. A waiver of subrogation applies. City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Purchasing DIVIS[On THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g ACCORDANCE WITH THE POLICY PROVISIONS, 215 N Mason St, 2nd Floor PO BOX 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) 1 of 1 The ACORD name and logo are registered marks of ACORD #S615948/M615935 NIK