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Home My WebLink About109445 CONNELL RESOURCES INC - INSURANCE CERTIFICATE (32)Client#: 14427 CONREI ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDFYYY) 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. O. Box 578 Greeley, CO 80632 970 356-0123 17 (.)' CONTACT NAME, Nikki Mosbrucker 'ONE g70 266-7123 970 506-6823 A/C Na Ext : A/C, Na AODH1Ess: In brucker@floodpeterson.com CUSTOMER ID #: INSURERS) AFFORDING COVERAGE NAIC # INSURED Connell Resources, Inc. 7785 Highland Meadows Parkway #100 Fort Collins, CO 80528 INSURER A: Travelers Insurance Company 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. TYPE OF INSURANCE D POLICY NUMBER MM/DDIYYYY XP MWDMYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CIAIMS-MADE F� OCCUR X X DTC04794N532- IND73 6/01/201306/01/201 EACH OCCURRENCE $1000000 PREMISES Ea occurence $300000 MED EXP (Any one person) $10,000 PERSONAL B ADV INJURY S1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE POLICYX OMIT APPLIES PER: PFrITRo- LOG PRODUCTS - COMP/OP AGO 52,000,000 S A AUTOMOBILE LIABILITY ANY AUTO ALL OW NED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS Other Car X X DT8104794N532- TIL13 6/01/2013 06/01/2014 COMBINED SINGLE LIMIT (Ea accident)) 51.000.000 BODILY INJURY (Per person) 3 BODILY INJURY (Per accident)$ I!Drive PROPERTY DAMAGE (Per accident)S S $ A X UMBRELLA LIAB EXCESS LIAB J( OCCUR CLAIMS -MADE DTSMCUP4794N- 532TIL13 Follows Form -- - 6/01/201306/01/201 EACH OCCURRENCE 510000000 AGGREGATE 51 O DOO OOO DEDUCTIBLE RETENTION S S B WORKERS COMPENSATION AND EMPLOYERS' UABILffY ANY PROPRIETOWPARTNERIEXECUTIVEY/ N OFFICER/MEMBER EXCLUDED? N (Mandatory In NH) If yes, describe under DE SCRIPTIONOFOPERATIONSt,dow N/A X 4029651 6/01/2013 06/01/2014 X WCSTATU- OTH- E.L. EACH ACCIDENT SSOO OOO E.L. DISEASE- EA EMPLOYEE 5500,005 E.LDISEASE-POUCVLIMIT 5500000 DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, B more apace Is required) RE: 7737 Asphalt Supply Services Agreement 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 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Purchasing Division ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 Fort Collins, CO 80522 j AUTHORIZED REPRESENTATIVE 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD #S789278/M789241 NIK Client#: 14427 CONREI ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DWYYYY) 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 CONTACT Nikki Mosbrucker NAME: Flood & Peterson lns.,Inc. PHONE g70 266-7123 970 506.6823 A/C No E. : AID, No P. O. Box 578 AooaEss: nmosbrucker4floodpeterson.com Greeley, CO 80632 970356-0123 CUSTOMER ID e: INSURER(S) AFFORDING COVERAGE NAICA INSURED INSURER A. Travelers Insurance Company Connell Resources, Inc. INSURER B: Plnna Col Assurance 7785 Highland Meadows Parkway #100 Fort Collins, CO 80628 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 ADDLSUBR POLICY NUMBER MWDMYV CY EXP MWDO/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABWTY CLAIMS -MADE 7 OCCUR X X DTC04794N532- IND13 6/01/2013 06/01/2014 EACH OCCURRENCE $1 ODD DOD DAMAGE TO RENTED PREMISES Ea occurrence s300000 MED EXP (Any one person) $10,000 PERSONAL&ACV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE POLICY LIMIT APPLIES PER: X PRO- ECTLOC PRODUCTS - COMP/OP AGG s2000000 $ A AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOSBODILY SCHEDULED AUTOS NON -OWNED AUTOS Drive Other Car X X DT8104794N532- TIL13 6/01/2013 06/01/2014 COMBINEDSINGLE LIMIT (Ea accident $1000000 BODILY INJURY(Par person) $ INJURY(Per accident) S 1XXX PROPERTY DAMAGEHIREDAUTOS (Per accident)$ S S A X UMBRELLA LIAB EXCESS LIAB OCCUR CIAIMS.MADE DTSMCUP4794N- 532TIL13 Follows Form 6/01/201306/01/201 EACH OCCURRENCE S10000000 N AGGREGATE_ S10000000 DEDUCTIBLE RETENTION S S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOMPARTNER/EXECUDVE OFFICERIMEMBER EXCLUDEOi ] (Mandatary In NH) It yes, describe under DESCRIPTION OF OPERATIONS below N!A X 4029651 6/01/2013 06/01/201 X WC STATU- OTH- E.L EACH ACCIDENT s500OOO E.L. DISEASE - FA EMPLOYEE s500,000 E.L. DISEASE - POLICY LIMIT $500 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: CRI# - Annual Snow & Ice Removal The City, its officers, agents and employees are named as additional insured, but only as respects liability arising out of work performed by the named insured. A waiver of subrogation applies. City of Fort Collins PO Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2009/09) 1 Of 1 #S789269/M789241 01988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NIK Client#: 14427 CONREI ACORD CERTIFICATE OF LIABILITY INSURANCE DATE TE(MMD 3YYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Flood & Peterson Ins., Inc. P. O. Box 578 Greeley, CO 80632 970 356-0123 CONTACT NAME, Nikki Mosbrucker PHGNE 970 266-7123 970 506-6823 A/C No Eat : A/C, No ADDRESS: nmosbrucker@floodpeterson.com CUSTOMER ID #: INSURER($) 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. INSR LILL TYPE OF INSURANCE DOL UBR POLICY NUMBER (MMDD/VVYY (MM/DD/YVVY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE [� OCCUR X X DTC04794N532- IND73 6/01/2013 06/01/2014 EACH OCCURRENCE $1000000 DAMAGE TO NT PREMISES (Eaoccurrence)$3DD000 MED EXP (Any one person) $10,000 PERSONAL &ADV INJURY $1,000,000 GENERALAGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY F X PRO- LOC PRODUCTS - COMP/OP AGO $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NONOWNEDAUTOS Drive Other Car X X DT8104794N532- TIL13 6/01/2013 06/01/2014 COMBINED 'SINGLE OMIT $1000000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ X $ A )(UMBRELLA LIAR EXCESS LIAB X OCCUR CLAIMS -MADE DTSMCUP4794N- 532TIL13 Follows Form 6/01/201306/01/201 EACH OCCURRENCE $10000000 AGGREGATE $10000000 DEDUCTIBLE RETENTION $ S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEY OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) if yes, describe under DESCRIPTION OF OPERATIONS below N/A X 4029651 6/01/2013 06/01/201 X WG STATU- OTH- E.L. EACH ACCIDENT $500,000 E.L DISEASE - EA EMPLOYEE $500,000 E.L. DISEASE -POLICY LIMIT $500000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) RE: CRI#2121036; BRT Phase 5 On -Call 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. AUTHORIZED REPRESENTATIVE ACORD 25 (2009109) 1 of 1 #S789268/M789241 m 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NIK Client#: 14427 CONREI ACORD. CERTIFICATE OF LIABILITY INSURANCE DA DD/YYVY) 5/29/229/2013 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 NAME, CONTACTNikki Mosbrucker PHONE 970 266-7123 we No Ext :(A/C,,,): 970 506-6823 aoDREss: nmoSbrucker@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, L TYPE OF INSURANCE POLICY NUMBER MWDDNYYY MWOMYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F OCCUR X X DTC04791 IND13 6/01/2013 06/01/2014 EACH OCCURRENCE $1000000 PREMISES Ea occurrence s300000 MED EXP (Any one person) $10,000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE POLICY LIMIT APPLIES PER: X PIFCT R0. n LOC PRODUCTS- COMP/OP AGG $2,000,000 S A AUTOMOBILE LIABILITY ANV AUTO ALL OWNED AUTOS SCHEDULED AUTOS AUTOS NON -OWNED AUTOS Drive Other Car X X DT8104794N532- TIL73BODILY 6/01/2013 06/01/2014 COMBINED SINGLE LIMIT (Ea accident $1000000 INJURY I Per person) S BODILY INJURY(Per accident) S 1XXX PROPERTY DAMAGEHIRED (Per accidentS $ $ A X UMBRELLA LIAR EXCESS LIAB X OCCUR CLAIMS -WOE DTSMCUP4794N- 532TIL13 _ Follows Form 6/01/2013 06/01/2011 EACH OCCURRENCE $10000000 AGGREGATE. t _ s10,000,000 DEDUCTIBLE RETENTION 5 $ S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ NLIMITS ANY PROPRIETOR/PARTNER/EXECUTIVE❑ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) II yyes, describe under DESCRIPTION OF OPERATIONS below WAE.L.EACH X 4029651 6/01/2013 O6/01/201 X WC STATU- OTH- ER ACCIDENT $500,000 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, B more space is metered) RE: CRI# 2121054 - 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 Purchasing Division SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 215 N Mason St, 2nd Floor PO Box 580 1 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 #S789277/M789241 NIK Client#: 14427 CONREI ACORD CERTIFICATE OF LIABILITY INSURANCE TE(MMDDfY rY) F DATE 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 endorsemer t(S). PRODUCER Flood & Peterson Ins., Inc. P. O. Box 578 Greeley, CO 80632 970 356.0123 NAME; CONTACTNikki Mosbrucker PHONE g70 266-7123 ac No Ext : wc, No : 970 506-6623 ADDRESS: nmoSbrucker@floodpeterson.com CUSTOMER ID e: INSURERIS) AFFORDING COVERAGE NAIC r INSURED Connell Resources, Inc. 7785 Highland Meadows Parkway #100 Fort Collins, CO 80528 INSURER A: Travelers Insurance Company 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. L UL TYPE OF INSURANCE POLICY NUMBER MOALuIDMY FF MMIDD/YYP LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL UABIUTY CLAIMS -MADE 51 OCCUR X X DTC04794N532- IND13 6/01/2013 06/01/2014 EACH OCCURRENCE $1000000 PREMISES(Eaoccurrence) $300000 MED EXP (Any one person) $10,000 PERSONAL B ADV INJURY $1,000,000 GENERALAGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY F X PRO- LOC PRODUCTS - COMP/OP AGG $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS Drive Other Car X X I DT8104794N532- TIL73 6/01/2013 06/01/2014 COMBINED SINGLE LIMIT (Ea accident) $1 ODOODO X BODILY INJURY (Par person) S BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Pera«ident) $ X X $ X $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE DTSMCUP4794N- 532TIL13 Follows Form 6/01/2013 06/01/2014 EACH OCCURRENCE S10000000 AGGREGATE $1 O 00D 000 DEDUCTIBLE RETENTION S $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVEY/N OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes.descdbe under DESCRIPTION OF OPERATIONS below N/A X 4029651 6/01/2013 06/01/207 X WC $TATU- OTH- E. L EACH ACCIDENT S500000 E.L DISEASE - EA EMPLOYEE $SDD,DDD E.L DISEASE - POLICY LIMIT 1 S500D00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It more space is required) 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 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 2 #S789276/M789241 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 DTE ADD/YYYY) 5/29/229/2013 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. O. Box 578 Greeley, CO 80632 970 356-0123 CONTACT NAME: Nikki MGsbrUcker PHONE 970 266-7123 A 970 506-6823 A/C No Ext : A/C, Ni AooRESS: nmosbrucker@floodpeterson.com CUSTOMER ID#: INSURER(S) AFFORDING COVERAGE NAIL # INSURED Connell Resources, Inc. 7785 Highland Meadows Parkway #100 Fort Collins, CO 80528 INSURER A: Travelers Insurance Company 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 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. TYPE OF INSURANCEUL dap- POLICY NUMBER MM/DDNYY MWDDNYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL UABWTY CLAIMS -MADE I -XI OCCUR X X DTC04794N532- IND13 6/01/2013 06/01/2014 EACH OCCURRENCE S1000000 DAMA T RENTED PREMISES Ea occurrence $3;0000 MED EXP (Any one person) $10,000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GENIE AGGREGATE 17 POLICY LIMIT APPLIES PER: X PRO LOC PRODUCTS - COMP/OP AGO $2,000,000 $ 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 COMBINEDSINGLE LIMIT (Ea accident) $1 DDD DDD X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accitlent) $ X X $ X $ A _ X UMBRELLA LIAR EXCESS UAB-fj I X OCCUR CLAIMS -MADE DTSMCUP4794N- 532TIL13 Follows Form 6/01/2013 06/01/2114 EACH OCCURRENCE $10000000 AGGREGATE $10000000 DEDUCTIBLE RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N 7N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A X 4029651 6/01/2013 06/01/201 X WCSTATu- OTH- RE E.L. EACH ACCIDENT SSOO DD0 EL.DISEASE -EA EMPLOYEE $SDO,ODO E.L. DISEASE -POLICY LIMIT $SDD DDD DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Aaach ACORD 101, Additional Remarks Schedule, d more space Is required) RE: CRI#2101003; 7089 Water, Wastewater, Stormwater Infrastructure The City of Fort Collins, its officers, agents and employees are (See Attached Descriptions) City of Fort Collins Financial Services- Purchasing P.O. 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. ACORD 25 (2009/09) 1 of 2 #S789275/M789241 @ 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Client#: 14427 CONRE7 ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(Mw00/YYYY) 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 CONTACT Nikki Mosbrucker NAME: Flood & Peterson Ins., Inc. a.NN Exl: "0 266-7123 MAC, Na: 970 506-6823 P. O. Box 578 AODREsS. nmosbrucker@floodpeterson.com Greeley, CO 80632 970 356-0123 CUSTOMER ID N: INSURER(S) AFFORDING COVERAGE NAICIf INSURED INSURER A: Travelers Insurance Company Connell Resources, Inc. Pinnacol Assurance 7785 Highland Meadows Parkway #100 INSURER B: Fort Collins, CO 80528 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. L TYPE OF INSURANCE POLICY NUMBER MOM%DMYY Y EFF MWDO/YVYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL UABIUTY CLAIMS -MADE 51OCCUR X X DTC04794N532- IND13 6/01/2013 06/01/2014 EAGHOCCURRENCE $1 OOO OOO DAMAGE TO PREMISES HEN rtDece s3000OO MED EXP(Any one person) $10,000 PERSONAL B ADV INJURY S1,000,000 GENERAL AGGREGATE 52,000,000 GENL AGGREGATE POLICY UNIT APPLIES PER: X PRa LOC PRODUCTS - COMP/OP AGG 52,000,000 S 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 attident) $1000000 X BODILY INJURY (Per person) S BODILY INJURY (Per attid.nt) $ PROPERTY DAMAGE (Per accident) $ X IX X S $ A X UMBRELLA LIAB E%LESS LIAB X OCCUR CLAIMS -MADE DTSMCUP4794N- 532TIL13 Follows Form 6/01/201306/01/201 EACH OCCURRENCE $10-000000 AGGREGATE $10000 000 DEDUCTIBLE RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOWPARTNERIEXECUTIVE OFFICERIMEMHER EXCLUDED? F (Mandatory In INN) If yes. descnbe under OE SCRIPTION OF OPERATIONS below NIA X 4029651 6/01/2013 06/01/201 X WC STATU- 0TH- ITS ER E.L. EACH ACCIDENT $500000 E.L. DISEASE - EA EMPLOYEE $500:000 E.L. DISEASE -POLICY LIMIT I 5500000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule. If more apace Is required) RE: CRI# 2121045 Turnberry Road 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 Finance Dept - Purchasing 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 #S789274/M789241 NIK Client#: 14427 CONREI ACORDrr. CERTIFICATE OF LIABILITY INSURANCE F DATE(MM/DO/YYYY) 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 NAME: CONTACT Nikki Mosbrucker Flood & Peterson Ins., Inc. _ PHONE 970 266-7123 97 AIC No Ext : AIC. No : 0 506-6823 P. O. Box 578 ADDRESS: nmosbrucker@floodpeterson.com Greeley, CO 80632 970356-0123 CUSTOMER ID INSURER(S) AFFORDING COVERAGE NAIC# INSURED INSURER A: Travelers Insurance Company Connell Resources, Inc. INSURER e: Pinnacol Assurance 7785 Highland Meadows Parkway #100 Fort Collins, CO 80528 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. 1.111- TYPE OF INSURANCE POLICY NUMBER (MM/DD/VYYY MM/DDNYVY LIMITS A GENERALLIABILITY X COMMERCIAL GENERAL LIABWTY CLAIMS -MADE OCCUR X X DTC04794N532- IND13 I 06/01/2013 06/01/2014 IS EACH OCCURRENCE $1 000000 PREMISES Ea occurrence s3000OO MED EXP(Any one person) S10,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GENL AGGREGATE LIMIT APPLIES PER: RO- LOCI POLICY X PJFCT PRODUCTS - COMP/OP AGO s2,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS OWNED AUTOS Drive Other Car X X DT8104794N532- TIL13 6/01/2013 06/01/2014 COMBINED SINGLE LIMIT (Ea accident) $1 000000 BODILY INJURY(Per person) $ BODILY INJURY(Per accident) $ 1XXX PROPERTY DAMAGE (Peraccident)NON $ $ A j( UMBRELLA LIAB EXCESS LIAB I X I OCCUR ..,MS MADE DTSMCUP4794N- 532TIL13 Follows Form 6/01/2013 06/01/2014 EACH OCCURRENCE S10000000 ri AGGREGATE S10,000,000 DEDUCTIBLE RETENTION S S $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEY/N OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA X 4029651 6/01/2013 06/01/2014 X WC STATU- OTH- E, L. EACH ACCIDENT s5000OO E.L. DISEASE - EA EMPLOYEE s500,000 E.L DISEASE -POLICY LIMIT 1 s5000OO DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (ANech ACORD 101, Additional Remarks Schedule. if more apace Is required) RE: Contractors Right of Way License Certificate holder is named as additional insured, but only as respects (See Attached Descriptions) City of Fort Collins Engineering Dept.; Attn: Lily 281 North College Ave PO Box 580 Fort Collins, CO 80522-0580 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 2 #S789273/M789241 01988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NIK Client#: 14427 CONREI ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATEIMM/OD/YYYY) 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 NAME. Nikki Mosbrucker Flood & Peterson Ins., Inc. PHONE 970 266-7123 970 506-6823 A/C No ExI : A/C, Na P. O. Box 578 AooREss: nmoSbrucker@floodpeterson.com Greeley, CO 80632 970 356-0123 CUSTOMER ID C INSURER(S) AFFORDING COVERAGE NAIC If INSURED INSURER A: Travelers Insurance Company Connell Resources, Inc. INSURER B : Pinnacol Assurance 7785 Highland Meadows Parkway #100 Fort Collins, CO 80528 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. LIEL TYPE OF INSURANCE SR VD POLICY NUMBER MMIDD/YYYY MM/DONYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY 71 CI -AIMS MADE 5XIOCCUR X X DTC04794N532- IND13 6/01/2013 06/01/2014 EACHOCCURRENCE $1000000 PREMISES(Ea occurrence s3000OO MED EXP(Any one person) $10,000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POUCY X PRO- JECTLOC PRODUCTS - COMP/OP AGG s2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS AUTOS AUTOS NON OWNED AUTOS Drive Other Car X X DT8104794N532- TIL13 6/01/2013 06/01/2014 COMBINEDSINGLE LIMIT (Ea accident) $1000000 BODILY INJURY(Per person) $ BODILY INJURY(Per accident) $SCHEDULED 1XXX PROPERTY DAMAGEHIRED (Per accident)S $ $ A X UMBRELLA LIAB EXCESS LIAB OCCUR CWIMS.MADE DTSMCUP4794N- 532TIL13 Follows Form 6/01/2013 06/01/2014 EACH OCCURRENCE $10000000 N AGGREGATE $10000000 DEDUCTIBLE RETENTION S $ B WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEY/N OFFICER/MEMBER EXCLUDED? F IN (Mandatory in NH) I(yes. describe under DE Ins,OF OPERATIONS below N/A X 4029651 6/01/2013 O6/01/201 X WC STATU- OTH- E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEE S500,000 EL DISEASE - POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES (ANach ACORD 101, Additional Remarks Schedule, If more space is required) RE: CRI# 2121056 - 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. ACORD 25 (2009/09) 1 Of 1 #S789272/M789241 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 DATE (MM/DD/YYYY) 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. O. Box 578 Greeley, CO 80632 970356-0123 CONTACT NAME: Nikki MOsbrucker PHONE g70 266-7123 970 506-6823 AIC No E#: MC, No: ADDRESS: nmosbrucker@fIoocIpeterson.conT CUSTOMER ID#: INSURER(5)AFFORDING COVERAGE NAIC# INSURED Connell Resources, Inc. 7785 Highland Meadows Parkway #100 Fort Collins, CO 80528 INSURER A: Travelers Insurance Company INSURER e: Pinnacol Assurance INSURER C: INSURER O: 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 INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHIC CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TE EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY NUMBER POLICY M DD/YYYY Y EXP (MM/DDNYYY LIMIT W A GENERAL LIAaILTY X COMMERCIAL GENERALLIABIUTY CLAIMS -MADE OCCUR X X DTC04794N532- IND73 I3 6/01/2013 06/01/2014 EACH OCCURRENCE PREMISES EaaccurIEW-E.nce MED EXP(Any one person) PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE s2 00-0 00O GEN'L AGGREGATE POLICY X LIMIT APPLIES PER: PRO- LOCI PRODUCTS - COMP/OP 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 OMIT (Ea a«Idenq $1,000,000 BODILY INJURY (Per person) S BODILY INJURY (Per accident) S 1XXX PROPERTY DAMAGE (Per accident) S $ I $ A )(UMBRELLA LIAR EXCESS LIAR X OCC CLAIMSUfl -MADE DTSMCUP4794N- 532TIL13 Follows Form 6/01/201306/01/201 EACH OCCURRENCE $10000000 AGGREGATE S10,000,000 DEDUCTIBLE RETENTION $ S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOWPARTNER/EXECUTIVEV/N OFFICER/MEMBER EXCLUDED? F (Mandatory In NH) It yes, dauriba under DE SCRIPTION OF OPERATIONS below N/A X 4029651 6/01/2013 06/01/201 X Tw&sTATU- OTH- E. L EACH ACCIDENT $500000 EL DISEASE - EA EMPLOYEE S500,000 EL DISEASE -POLICY LIMIT S500000 DESCRIPTION OF OPERATIONS LOCATIONS VEHICLES (Attach ACORD 101. Additional Remarks Schedule, if mare space is required) RE: CRI# 2121046 - BRT Phase 6, Prospect Road 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. AUTHORIZED REPRESENTATIVE ACORD 25 (2009/09) 1 Of 1 #S789271/M789241 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 DATE TE(MMDD3YYY) 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 endorsement(s). PRODUCER Flood & Peterson Ins., Inc. P. O. Box 578 Greeley, CO 80632 970 356-0123 CONTACT Nikki Mosbrucker NAME: IN 970 266-7123 970 506-6823 AIC No Est : A/C. No AODRESs: nmosbrucker@fioodpeterson.com CUSTOMER ID a: INSURER(S) AFFORDING COVERAGE NAICa INSURED Connell Resources, Inc. 7785 Highland Meadows Parkway #100 Fort Collins, CO 80528 INSURER A: Travelers Insurance Company 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 INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHIC CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TE EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. L TYPE OF INSURANCE POLICY NUMBER MWDONYF XP WDD/YYY LIMIT W A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMSMADE OCCUR X X DTC0479414532- IND73 6/01/201306/01/207 EACH OCCURRENCE DAMAGE TO REPT91F PREMISESEaxcunenca MED EXP (Any one person) PERSONAL& ADV INJURY $1,00,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POUCV X PRO- JECT LOG PRODUCTS - COMP/OP AGO $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS Drive Other Car X X DT8104794N532- TIL73 6/01/2013 06/0112014 COMBINED SINGLE LIMIT (Ea a«idenn $11000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per aaidem) $ 1XXX PROPERTY DAMAGE (Per accident)$ $ S A )( UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE DTSMCUP4794N- 532TIL13 Follows Form 6/01/2013 06/01/101 EACH OCCURRENCE $10 000 000 N AGGREGATE S101000,000 DEDUCTIBLE RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE V / N OFFICER/MEMBER EXCLUDED? � (Mandatory In NH) Ii yes. describe under DESCRIPTION OF OPERATIONS below WA X 4029651 6/01/2013 06/01/2014 X WCSTATU- OTH- E.L. EACH ACCIDENT $500 OOO E.L. DISEASE - EA EMPLOYEE $500:000 E.L DISEASE -POLICY LIMIT S500,000 DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks schedule, If more spec, is required) RE: CRI# 2111048 - N. College Improvements Project Vine -Conifer The City of Fort Collins, its officers, agents and employees and Stantec Consulting Services, Inc. are (See Attached Descriptions) City of Fort Collins 215 N Mason St Fort Collins, CO 80524 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 2 #S789270/M789241 01988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NIK