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Home My WebLink About109445 CONNELL RESOURCES INC - INSURANCE CERTIFICATE (33)Client#: 14427 CONREI ACORD. CERTIFICATE OF LIABILITY INSURANCE I 0ATE (MWDDIYYYY 3/04/2014 1 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. 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). Flood & Peterson Ins., Inc. PHONEOo • 970266-7123 Np; 970506-6823 P. O. Box 578 M:imosbrucker@floodpetemon.com Greeley, CO 80632 E CUSTOMER ID It: 970 356-0123 INSURER 8 AFFORDING COVERAGE NAIC $ INSURED INSURER A: Travelers Insurance Company Connell Resources, Inc. /Q Q4Lf-S INSURER B: Pinnacol Assurance 7785 Highland Meadows Parkway #100 1 1 1 INSURER C Fort Collins, CO 80528 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 IELTYPE OF INSURANCE X POLICY NUMBER FF MWDD ENYYY POLICY EXP MMIOD LIMITS A GENERALUABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 51 OCCUR X DTC04794N532- IND13 6101/2013 06101/2014 EACH OCCURRENCE $1000000 PREMISES Eaoccuramoe $300000 MED EXP (". person) $10 000 PERSONAL S ADV INJURY $1 000 000 GENERALAGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 17 POLICY X PRO LOCI PRODUCTS - COMP/OP AGO 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 6101/2013 0610112014 COMBINED SINGLE LIMIT (Ea accident) S 1000000 X BODILYIWILRY(Perpenon) $ BODILY INJURY(Peraaltlenl) $ X X PROPERTY DAMAGE (Per accident) $ $ X $ A X UMSRELLAUAB EXCESS LIAB X OCCUR CWMS-MADE DTSMCUP4794N- 532TIL13 Follows Form 51011201306/011201 EACH OCCURRENCE $10000000 AGGREGATE $10000000 DEDUCTIBLE RETENTION $ : B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORJPARTNERIEXECUTIVEYIH OFFICER/MEMBER EXCLUDED? (Mandatory In NH) describe under DESCRIPTION OF OPERATIONS Wpa, WA X 4029651 6/01/2013 06101/2014 X I WC STATU- I OTH E.L. EACH ACCIDENT $500,000 $500,000 $500000 E.L. DISEASE -EA EMPLOYEEIf E.L. DISEASE, POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: CRI# 2141014 - Plum Street Sewer 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 ACORD 25 (2009/09) 1 Oft #S868325/M789241 01988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD KXM