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Home My WebLink About109445 CONNELL RESOURCES INC - INSURANCE CERTIFICATE (31)Client#: 14427 CONREI ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIOD'YYY) F 5/29/2013 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. 0. Box 578 Greeley, CO 80632 970 356-0123 , O CONTACT NAME, Nikki Mosbrucker PHONE 970 266-7123 970 506-6823 A/C No Eh : AIC, No ao A'SS. nmo.brucker@floodpeterson.com CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Travelers Insurance Company Connell Resources, Inc. 7785 Highland Meadows Parkway #100 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. LTIL TYPE OF INSURANCE POLICY NUMBER MOMID�YY MMIDONYVY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [� OCCUR X X DTC04794N532- IND73 6/01/2013 06/01/2014 EACH OCCURRENCE s1000000 DAMAGE TO RENTED PREMISES Ea occurrence s300000 , MED EXP (Any one person) $10,000 PERSONAL& ADV INJURY S1,000,000 GENERAL AGGREGATE s2,000,000 GENT AGGREGATE POLICY 7X LIMIT APPLIES PER: PRP LOCI PRODUCTS - COMPIOP AGG s2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS Drive Other Car X X DT8104794N532- TIL13 6/01/2013 06/01/2014 COMBINED SINGLE UMIT (Ea acmidend $11000,000 X BODILY INJURY (Per person) S BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Peraccident) $ X X $ X S A X UMBRELLA JAB EXCESS LABZIM5-MADE X OCCUR DTSMCUP4794N- 532TIL13 Follows Form 6/01/201306101/201 EACH OCCURRENCE $10000000 AGGREGATE $1000D 000 16111TIBLE RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERJEXECUTIVE N1 OFFICERIMEMBER E%CLUDEO? N (Mandatory in NH) II yes. des rroe under DESCRIPTION OF OPERATIONS below NIA X 4029651 6101/2013 06/01/2014 X WCBTATU- OTH- EA_ EACH ACCIDENT s500OOO EL DISEASE - EA EMPLOYEE S500,000 E.L. DISEASE - POLICY LIMIT $500000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarde Schedule, If more apace la required) RE: CRI# 2131009 - 3M CIP Lining Project IN Mason St, Plum St, Quail Hollow Water Main 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 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. AUTHORIZED REPRESENTATIVE ACORD 25 (2009/09) 1 of 1 #S789267/M789241 01988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NIK