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Home My WebLink About109445 CONNELL RESOURCES INC - INSURANCE CERTIFICATE (17)Client#: 14427 CONREI ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/OD/YYYY) F 4/27/2012 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. P. O. Box 578 Greeley, CO 80632 970 356-0123 NAME: CONTACT Nikki Mosbrucker PHONE 970-266-7123 FAX we No Ext : MAC, a): 970-506-6823 E-MAIL ADDRESS: nikki-mosbrucker@fpinsurance.com PRODUCER CUSTOMEFTC full cert R ID N: INSURERS) AFFORDING COVERAGE NAIL If INSURED INSURER A; Travelers Insurance Company OO �\ Connell Resources, Inc. \ % 7785 Highland Meadows Parkway Fort Collins, CO 80528 INSURER 8, 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 LTR TYPE OF INSURANCE DDL N R UBR WD POLICY NUMBER POLICY EFF MWODNYYY POLICY EXP MM/DONYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY _ CLAIMS -MADE EXIOCCUR DTC04794N532- IND71 6/01/2011 06/01/2012 EACH OCCURRENCE $1000000 GETO -RENTED PREMISES Ea occurrence) $30D 000 MED EXP(Any one person) $10,000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: ErT17 POLICY X PRO LOC PRODUCTS - COMP/OP AGG s2,000,000 $ A AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS Drive Other Car DT8104794N532- TIL11 I 6/01/2011 06/01/2012 COMBINED SINGLE LIMIT (Ea accident) $1000000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accitlenQ $ PROPERTY DAMAGE (Per accident) $ X X $ X $ A X UMBRELLA LIAR EXCESS UAB X OCCUR CLAIMS -MADE I DTSMCUP4794- N532TIL11 6/01/2011 06/01/2012 EACH OCCURRENCE $10-000000 AGGREGATE $10000000 DEDUCTIBLE RETENTION $ $ S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNEPEXECUTIVEY YIN OFFICER/MEMBER EXCLUDED? (Mandatory In NH) It yes, describe under DESCRIPTION OF OPERATIONS below WA 4029651 6/01/2011 06/01/201 X WC STATU- OTH- E.L. EACH ACCIDENT s500,000 E.L. DISEASE EA EMPLOYEE $500,000 E.L. DISEASE - POLICY LIMIT s500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more apace is required) RE: CRI# 2121532 - Emergency Repair Mobilization 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. 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 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) 1 of 1 #S691954/M615935 The ACORD name and logo are registered marks of ACORD SXC