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HomeMy WebLinkAbout109445 CONNELL RESOURCES INC - INSURANCE CERTIFICATE (60)A� " CERTIFICATE OF LIABILITY INSURANCE DATE (MWDDNYY 5/28/2015 Y) 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 and Peterson PO Box 578 Greeley CO 80632 CONTACT Nikki Mosbrucker CIC, CISR NAME: AX PHONEExtI, (970) 266-7123 FJC No): (970)506-6823 EA -MAIL NMosbrucker@floodpeterson.com INSURERS AFFORDING COVERAGE NAIC If INSURERA:Charter Oak Fire Insurance 25615 INSURED Connell Resources, Inc. 7785 Highland Meadows Parkway #100 Fort Collins CO 80528 INSURERB:TraVelers Indemnity Company 25658 INSURERC:Travelers Property Casualty 25674 INSURERD:Pinnacol Assurance 1190 INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER:CL1552803110 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 ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F7X OCCUR X DTC04794N532COF15 5/1/2015 6/1/2016 DAMAGE TO RENTE PREMISES Ea ccurence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 71 POLICY X PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X T8104794N532TIL15 5/1/2015 6/1/2016 BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS X AUTOS Uninsured motorist combined $ 11000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10, 000, 000 C, EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ X DTSMCUP4794N532TIL15 6/1/2015 6/1/2016 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N X WC STATU- OTH- ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A 029651 6/1/2015 6/1/2016 E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 If yes. describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CRI # 2151005; Foothills Outfall Channel Cleaning 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. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 N Mosbrucker CIC, CISR ACORD 25 (2010/05) INS025 (201005).01 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACCORbr CERTIFICATE OF LIABILITY INSURANCE DATE r 5/28/2015 Y) 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 and Peterson PO Box 578 Greeley CO 80632 CONTACT Nikki Mosbrucker CIC, CISR NAME: PHONE (970)266-7123 FAX (970)506-6823 No_A/C No : E-MAIL)FIESS.NMosbrucker@floodpeterson.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:Charter Oak Fire Insurance 25615 INSURED Connell Resources, Inc. 7785 Highland Meadows Parkway #100 Fort Collins CO 80528 INSURERB:Travelers Indemnity Company 25658 INSURERC:Travelers Property Casualty 25674 INSURERD:Pinnacol Assurance 41190 INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER:CL1552803110 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 ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YVYV POLICY EXP MM/DD/YYYV LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $ 300,000 A CLAIMS -MADE aOCCUR X DTC04794N532COF15 /1/2015 6/1/2016 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO BODILY INJURY Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS X T8104794N532TIL15 6/1/2015 6/1/2016 NON -OWNED HIRED AUTOS X AUTOS X PROPERTY DAMAGE Per accident $ Uninsured motorist combined $ 11000,000 X UMBRELLA LAB X OCCUR EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10, 000, 000 C EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ X DTSMCUP4794N532TIL15 6/1/2015 6/1/2016 D WORKERS COMPENSATION Y X WC STATU- OTH- ER AND EMPLOYERS' LIABILITY V / NI E.L. EACH ACCIDENT $ 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N❑ N / A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) 4029651 6/1/2015 6/1/2016 E.L. DISEASE - EA EMPLOYEE $ 500,000 If yes. describe under E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: CRI# 2151505 - Integrated Recycling Facility 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. ;.cn I iris n I r nvwrn GANGtLLA I IUN 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 (2010/05) INS025 (201005).01 Mosbrucker CIC,CISR ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD '`'C"R br CERTIFICATE OF LIABILITY INSURANCE DATE 5/28/2015 Y) 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 and Peterson PO Box 578 Greeley CO 80632 CONTACT NAME: Nikki Mosbrucker CIC, CISR PHONE (970)266-7123 FAX A/C No(970)506-6823 E-MAIL NMosbrucker@floodpeterson.com ADRESS INSURERS AFFORDING COVERAGE NAIC p INSURERA:Charter Oak Fire Insurance 25615 INSURED Connell Resources, Inc. 7785 Highland Meadows Parkway #100 Fort Collins CO 80528 INSURERB:Travelers Indentnity Company 25658 INSURERC:Travelers Property Casualty 25674 INSURERD:Pinnacol Assurance 1190 INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER:CL1552803110 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 ADDL SUBR POLICY NUMBER POLICY EFF MM/DDNYYY POLICY EXP MM/DDNYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX_1 OCCUR DTC04794NS32COF15 6/1/2015 6/1/2016 AMA NTED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO- JECTLOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X T8104794N532TIL15 6/1/2015 6/1/2016 BODILY INJURY (Per accident) $ X NON -OWNED HIRED AUTOS X AUTOS PROPERTY DAMAGE Per accident $ Uninsured motorist combined $ 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10,000,000 C EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ X DTSMCUP4794N532TIL15 6/1/2015 6/1/2016 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / NCRY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A Y 029651 6/1/2015 6/1/2016 X I WC STATUS OTH- E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space 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. CERTIFICATE HOLDER CANCELLATION 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 (2010/05) INS025 (201005).01 N Mosbrucker CIC, CISR ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD '4� " CERTIFICATE OF LIABILITY INSURANCE Y) 5/28/2015 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 and Peterson PO Box 578 Greeley CO 80632 CONTACT Nikki Mosbrucker CIC, CISR NAME: PHONEN. (970)IA 266-7123 FAX No: (970)506-6823 E-MAIL .NMosbrucker@floodpeterson.com ADDRESS INSURERS AFFORDING COVERAGE NAIC # INSURERA:Charter Oak Fire Insurance 25615 INSURED Connell Resources, Inc. 7785 Highland Meadows Parkway #100 Fort Collins CO 80528 INSURERB:Travelers Indemnity Company 25658 INSURERC:Travelers Property Casualty 25674 INSURERD:Pinnacol Assurance 41190 INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER:CL1552803110 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 ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxI OCCUR X DTC04794N532COF15 6/1/2015 6/1/2016 DAMAGE TRENTED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE A LIABILITY COMBINED SINGLE LIMIT Eaaccident 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X T8104794N532TIL15 5/1/2015 6/1/2016 BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED AUTOS X NON -OWNED AUTOS Uninsured motorist combined $ 1 000 000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10,000,000 C EXCESS LIAB CLAIMS -MADE DIED I I RETENTION$ $ X DTSMCUP4794N532TIL15 6/1/2015 6/1/2016 D WORKERS COMPENSATION EMPLOYERS' LIABILITY Y / N g X I WC STATU- OTH- OR'LIMITAND S ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A 4029651 6/1/2015 6/1/2016 E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYE $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Asphalt Supply 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. CERTIFICATE HOLDER CANCELLATION 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 (2010/05) INS025 (201005).01 Mosbrucker CIC, CISR © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACOR6r CERTIFICATE OF LIABILITY INSURANCE DATE(MWDONYYY) 5/28/2015 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 and Peterson PO Box 578 Greeley CO 80632 CONTACT NAME:Nikki Mosbrucker CIC, CISR NAME: PHO,JCNE (970)266-7123 FAX No (970)506-6823 E-MAIL .NMosbrucker@floodpeterson.com ADDRESS INSURERS AFFORDING COVERAGE NAIC # INSURER A:Charter Oak Fire Insurance 25615 INSURED Connell Resources, Inc. 7785 Highland Meadows Parkway #100 Fort Collins CO 80528 INSURERB:Travelers Indemnity Company 25658 INSURERC:Travelers Property Casualty 25674 INSURERD:Pinnacol Assurance 1190 INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER:CL1552803110 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 ADDL SUBR POLICY NUMBER POLICY EFF MM/DDNYYY POLICY EXP MM/DDNYYV LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $ 300,000 A CLAIMS -MADE aOCCUR X Y DTC04794N532COF15 6/1/2015 6/1/2016 VIED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1 0 0 0 0 0 0 X BODILY INJURY (Per person) $ B ANY AUTO (Per BODILY INJURY accident) $ ALL OWNED SCHEDULED AUTOS AUTOS X Y T8104794N532TIL15 6/1/2015 6/1/2016 NON -OWNED HIRED AUTOS N AUTOS X PROPERTY DAMAGE Per accident $ Uninsured motorist combined $ 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10, 000, 000 C, EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ X Y DTSMCUP4794N532TIL15 6/1/2015 6/1/2016 D WORKERS COMPENSATION y X I WC STATUS OTH- ER AND EMPLOYERS' LIABILITY Y / NI E.L. EACH ACCIDENT $ 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N❑ N / A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) 029651 6/1/2015 6/1/2016 E.L. DISEASE - EA EMPLOYEE $ 500,000 If yes, describe under E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) RE: CRI# 2141026 - College Avenue (US 287) Mulberry St to one block south of Pitkin St The City, its officers, agents and employees; and Colorado Department of Transportation are 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. CERTIFICATE HOLDER CANCELLATION 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 ACUHU 25 (2010/05) INS025 (201005).01 Mosbrucker CIC,CISR ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AC40R " CERTIFICATE OF LIABILITY INSURANCE F DATE YY) 5/28/2015 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 and Peterson PO Box 578 Greeley CO 80632 CONTACT Nikki Mosbrucker CIC, CISR NAME: PHONE (970)266-7123 A/C No: (970)506-6823 AEbmoAi,'LESS,NMosbrucker@floodpeterson.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:Charter Oak Fire Insurance 25615 INSURED Connell Resources, Inc. 7785 Highland Meadows Parkway #100 Fort Collins CO 80528 INSURERB:Travelers Indemnity Company 25658 INSURERc:Travelers Property Casualty 25674 INSURERD:Pinnacol Assurance 41190 INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER:CL1552803110 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 ADDL SUBR POLICY NUMBER POLICY EFF MM/DDNYYY POLICY EXP MM/DDNYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X❑OCCUR X DTC04794N532COF15 6/1/2015 6/1/2016 DAMAGE TO RIN71- PREMISES Ea cc r ence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO LOC I $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X T8104794N532TIL15 /1/2015 6/1/2016 BODILY INJURY (Per accident) $ X HIRED AUTOS X NON -OWNED AUTOS PROPERTY RTY DAMAGE accident) $ Uninsured motorist combined $ 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 AGGREGATE S 10, 000, 000 C, EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ X TSMCUP4794N532TIL15 6/1/2015 6/1/2016 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N y X WC STATU- OTH- CRY LIMITS I I ER E.L. EACH ACCIDENT $ 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N❑ (Mandatory in NH) N/A 4029651 6/1/2015 6/1/2016 E.L. DISEASE - EA EMPLOYEE $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below 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# 2151024 - 8083 Misc Street Improvements 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. CtH I It-ICA I t HULUtH CANCELLA I IVN 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 (2010/05) INS025 (201005).01 Mosbrucker CIC, CISR C3��lA ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD R CERTIFICATE OF LIABILITY INSURANCE . 6.1—� `5 D28//DD/Y5 5/28/201 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(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 CIC, CISR NAME: Flood and Peterson PO Box 578 PHONE (970) 266-7123 FAX No: (970)506-6823 E-MAIL NMosbrucker@floodpeterson.com INSURERS AFFORDING COVERAGE NAIC # Greeley CO 80632 INSURERA:Charter Oak Fire Insurance 25615 INSURED INSURERB:Travelers Indentnity Company 25658 Connell Resources, Inc. INSURERC:Travelers Property Casualty 25674 7785 Highland Meadows Parkway #100 INSURERD:Pinnacol Assurance 41190 INSURER E Fort Collins CO 80528 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1552803110 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 ADDL SUBR WVDPOLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $ 300,000 A CLAIMS -MADE 7OCCUR X TC04794N532COF15 6/1/2015 6/1/2016 MEDEXP(Anyoneperson) $ 10,000 PERSONALSADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY FX JECT PRO LOC $ AUTOMOBILE LIABILITY SINGLE LIMIT EOaaBINEDi 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS X T8104794N532TIL15 6/1/2015 6/1/2016 X NON -OWNED HIRED AUTOS AUTOS X PROPERTY DAMAGE Per accident $ Uninsured motorist combined $ 1 000 000 X UMBRELLA LIAR N OCCUR EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10,000,000 C EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ X TSMCUP4794N532TIL15 6/1/2015 /1/2016 D WORKERS COMPENSATION y X I WC STATUS OTH- AND EMPLOYERS' LIABILITY Y / N E.L. EACH ACCIDENT $ 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N❑ N/A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) 029651 6/1/2015 6/1/2016 If yes, describe under E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: CRI# 2141066; #7089- Water Utilities Infrastructure; 451 Boardwalk Water Main Improvements 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 Al'Uriu ZO (ZUILI INS025 (201005).01 Mosbrucker CIC, CISR © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD R CERTIFICATE OF LIABILITY INSURANCE .6-.-/ ATE D/28/201/DD/Y5 528/5 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 and Peterson PO Box 578 Greeley CO 80632 CONTACT Nikki Mosbrucker CIC, CISR NAME: PHONE (970)266-7123 AX FNo (970)506-6823 E-MAIL .NMosbruckerQfloodpeterson.com ADRESS INSURERS AFFORDING COVERAGE NAIC # INSURERA:Charter Oak Fire Insurance 25615 INSURED Connell Resources, Inc. 7785 Highland Meadows Parkway #100 Fort Collins CO 80528 INSURERB:Travelers Indeninity Company 25658 INSURERC:Travelers Property Casualty 25674 INSURERD:Pinnacol Assurance 1190 INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER:CL1552803110 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 ADDL SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE aOCCUR X TC04794N532COF15 6/1/2015 6/1/2016 DAMA PREMISES (Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY EOMaBINdEeD nt�SINGLE LIMIT 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X DT8104794N532TIL15 6/1/2015 6/1/2016 BODILY INJURY (Per accident) $ HIRED AUTOS X NON -OWNED AUTOS X PROPERTY DAMAGE Per accident $ Uninsured motorist combined $ 1 000 000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10, 000, 000 C, EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ X DTSMCUP4794N532TIL15 6/1/2015 6/1/2016 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? F (Mandatory in NH) If yes, describe under N/A y 4029651 6/1/2015 6/1/2016 X I WC STATU- OTH- E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: CRI# 2131065 - West Vine Outfall-Earthwork 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. a,�n I irwr%I V. nvL.UF-n GANGtLLA I IVN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins Utilities PO BOX 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 N Mosbrucker CIC, CISR AC:UHU 2b (2UlU/Ub) INS025 (201005).01 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD '4� br CERTIFICATE OF LIABILITY INSURANCE DATE (MMJDD/YYY 5/28/2015 Y) 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 AME: Nikki Mosbrucker CIC, CISR N Flood and Peterson PO Box 578 PHONE (970) 266-7123 FAX (970)506-6823 A/C No EA -MAIL .NMosbrucker@floodpeterson.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:Charter Oak Fire Insurance 25615 Greeley CO 80632 INSURED INSURERB:Travelers Indemnity Company 25658 Connell Resources, Inc. INSURERC:Travelers Property Casualty 25674 INSURERD:Pinnacol Assurance 41190 7785 Highland Meadows Parkway #100 INSURER E : Fort Collins CO 80528 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1552803110 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 ADDL JUaL SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYV LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 X COMMERCIAL GENERAL LIABILITY DAmA PREMISES Ea ccur ante $ 300, 000 A CLAIMS -MADE OCCUR X DTC04794N532COF15 /1/2015 6/1/2016 MED EXP (Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS X T8104794N532TIL15 6/1/2015 6/1/2016 NON -OWNED HIRED AUTOS X AUTOS X PROPERTY DAMAGE Per accident) ccident $ Uninsured motorist combined $ 1,000,000 X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10,000,000 C,RED EXCESS LIAB CLAIMS -MADE RETENTION$ $ X TSMCUP4794N532TIL15 6/1/2015 6/1/2016 D WORKERS COMPENSATION i X WC STATU- OTH- CRY LIMER AND EMPLOYERS' LIABILITY Y / N E.L. EACH ACCIDENT $ 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N❑ N / A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) 4029651 6/1/2015 6/1/2016 E.L. DISEASE- EA EMPLOYEE $ 500,000 If yes, describe under E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) RE: CRI# 2151001 - 8046 Arthur Ditch Bridge Replacement The City of Fort Collins, its officers, agents and employees are is included as Additional Insured as required by written contract with respects to liability arising out of work performed by the named insured per written contract. The insurance evidenced by this certificate will not reduce coverage or limits and will not be cancelled, except after thirty (30) days written notice has been received by the City of Fort Collins. City of Fort Collins PO Box 580 Fort Collins, CO 80522 I IUN 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 AGUHU 25 (2UIU/U5) INS025 (201005) 01 Mosbrucker CIC, CISR © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE DATE 5/28/2015Yv) 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 and Peterson PO Box 578 Greeley CO 80632 CONTACT NAME: Nikki Mosbrucker CIC, CISR PHOIAIC,NE (970)266-7123 A/C No: (970)506-6823 EMAIL NMosbruckerQfloodpeterson.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:Charter Oak Fire Insurance 25615 INSURED Connell Resources, Inc. 7785 Highland Meadows Parkway #100 Fort Collins CO 80528 INSURERB:Travelers Indemnity Company 25658 INSURERC:Travelers Property Casualty 25674 INSURERD:Pinnacol Assurance 41190 INSURER E INSURERF: COVERAGES CERTIFICATE NUMBER:CL1552803110 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 ADDL SUBR POLICY NUMBER POLICY EFF MM/DDNYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X DTC04794N532COF15 6/1/2015 /1/2016 DAMAX PREM T RENT PREMISES Ea occurrence $ 300, 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: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X T8104794N532TIL15 6/1/2015 6/1/2016 BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ X NON -OWNED HIRED AUTOS AUTOS Uninsured motorist combined $ 11000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10, 000, 000 JDXD AGGREGATE $ 10, 000, 000 C CESS LIAB CLAIMS -MADE I I RETENTION$ $ X DTSMCUP4794N532TIL15 6/1/2015 6/1/2016 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N y X WC LIMIT ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? a (Mandatory in NH) N / A 4029651 6/1/2015 6/1/2016 E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below 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# 2141077 - Fossil Creek Stream Rehabilitation Phase 2 / WO# 5CP-FCSREP2-010215 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 GANGELLAi ION 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 N Mosbrucker CIC,CISR ACORD 25 (2010/05) INS025 (201005).01 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ® CERTIFICATE OF LIABILITY INSURANCE ACC?R " DATE (MWDDNYY r 5/28/2015 Y) 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 and Peterson PO Box 578 Greeley CO 80632 CONTACT Nikki Mosbrucker CIC, CISR NAME: PHONE (970) 266-7123 FAX No): (970)506-6823 E-MAIL NMosbrucker@floodpeterson.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:Charter Oak Fire Insurance 25615 INSURED Connell Resources, Inc. 7785 Highland Meadows Parkway #100 Fort Collins CO 80528 INSURERB:Travelers Indemnity Company 25658 INSURERC:Travelers Property Casualty 25674 INSURERD:Pinnacol Assurance 1190 INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER:CL1552803110 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 INSR WVD SUER POLICY NUMBER POLICY EFF MM DD/YYVV POLICY EXP MMIDD/YYYV LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7XIOCCUR X DTC04794N532COF15 6/1/2015 /1/2016 PREMDAMAGE T RENTED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X T8104794N532TIL15 6/1/2015 6/1/2016 (Per accident) ) BODILY INJURY (Pidt $ X NON -OWNED HIRED AUTOS X AUTOS PROPERTY DAMAGE Per accident $ Uninsured motorist combined $ 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10, 000, 000 C, EXCESS LIAB CLAIMS -MADE TIED RETENTION$ $ X DTSMCUP4794N532TIL15 6/1/2015 6/1/2016 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? FEN] (Mandatory in NH) N!A Y 4029651 6/1/2015 6/1/2016 X WC STATU- OTH- E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below 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# 2141048 - City #7089 -- 700 Block of Whalers Way Water Main Improvements 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 LeL•L'iIJ3RR_\ I Lei 9 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 (2010/05) INS025 (201005).01 Mosbrucker CIC, CISR © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD A� " CERTIFICATE OF LIABILITY INSURANCE DATE (MWDDNYY 5/28/2015 YI 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 and Peterson PO Box 578 Greeley CO 80632 CONTACT Nikki Mosbrucker CICCISR NAME: , PHONE (970) 266-7123 FAX NO: (970)506-6823 EMAIL .NMosbruckerQfloodpeterson.com ADDRESS INSURERS AFFORDING COVERAGE NAIC # INSURERA:Charter Oak Fire Insurance 25615 INSURED Connell Resources, Inc. 7785 Highland Meadows Parkway #100 Fort Collins CO 80528 INSURERB:Travelers Indenmity Company 25658 INSURERC:Travelers Property Casualty 25674 INSURERD:Pinnacol Assurance 1190 INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER:CL1552803110 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 ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYV POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1, OOO, OOO A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F_x1 OCCUR X DTC04794N532COF15 6/1/2015 6/1/2016 DAMAGE TO RENT1717-- PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GE AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO-LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X DT8104794N532TIL15 6/1/2015 /1/2016 BODILY INJURY (Per accident) $ X NON -OWNED HIRED AUTOS X AUTOS PROPERTY DAMAGE tPer accident $ Uninsured motorist combined $ 1 000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10, 000, 000 C, EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ X DTSMCUP4794N532TIL15 6/1/2015 6/1/2016 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If as, describe under DESCRIPTION OF OPERATIONS below N / A 4029651 6/1/2015 6/1/2016 XI WC STATU- OTH- E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYE9 $ 500,000 E.L. DISEASE- POLICY LIMIT 1 $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: CRI# 2141055 - Fossil Creek Stream Rehabilitation at Fossil Creek Community Park - Phase 1 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 N Mosbrucker CIC,CISR ACORD 25 (2010/05) INS025 (201005).01 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD '4C40R " CERTIFICATE OF LIABILITY INSURANCE F DATE Y) 5/28/2015 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 and Peterson PO Box 578 Greeley CO 80632 CONTACT Nikki Mosbrucker CIC, CISR NAME: PHONE (970) 266 -7123 FAX (970)506-6823 tA/CA/C No): E"MIIL .NMosbruckerQfloodpeterson.com DRESS INSURERS AFFORDING COVERAGE NAIC # INSURERA:Charter Oak Fire Insurance 25615 INSURED Connell Resources, Inc. 7785 Highland Meadows Parkway #100 Fort Collins CO 80528 INSURERB:Travelers Indenmity Company 25658 INSURERC:Travelers Property Casualty 25674 INSURERD:Pinnacol Assurance 1190 INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER:CL1552803110 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 ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYV POLICY EXP MM/DD/YVYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMA RENT PREMISES Ea occurrence $ 300, 000 A CLAIMS -MADE FTOCCURX DTC04794N532COF15 5/1/2015 5/1/2016 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY FX PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS X T8104794N532TIL15 6/1/2015 6/1/2016 X NON -OWNED HIRED AUTOS N AUTOS PROPERTY DAMAGE Per accident $ Uninsured motorist combined $ 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10, 000, 000 C, EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ X DTSMCUP4794N532TIL15 5/1/2015 6/1/2016 D WORKERS COMPENSATION g X WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N E.L. EACH ACCIDENT $ 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N / A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) 4029651 6/1/2015 6/1/2016 E.L. DISEASE - EA EMPLOYE $ 500,000 If yes, describe under E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: 7089 Water, Wastewater, Stormwater Infrastructure Design and Construction 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. .0 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 AGUHU 25 (ZUIU/US) INS025 (201005).01 Mosbrucker CIC,CISR © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AC" or CERTIFICATE OF LIABILITY INSURANCE 5/ E(MWDD 5 Y) 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 and Peterson PO Box 578 Greeley CO 80632 CONTACT AME: Nikki Mosbrucker CIC, CISR N PHONE (970) 266-7123 FAX (970)506-6823 Ext,A/C No : EAMARIL NMosbrucker@floodpeterson.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:Charter Oak Fire Insurance 25615 INSURED Connell Resources, Inc. 7785 Highland Meadows Parkway #100 Fort Collins CO 80528 INSURERB:Travelers Indemnity Company 5658 INSURERC:Travelers Property Casualty 25674 INSURERD:Pinnacol Assurance 41190 INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER:CL1552803110 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 ADDL SUBR POLICY NUMBER POLICY EFF MM/DDNYYY POLICY EXP MM/DDNYYV LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea ccur ence $ 300,000 A CLAIMS -MADE OCCUR X Y TC04794N532COF15 6/1/2015 6/1/2016 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO BODILY INJURY Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS X Y T8104794N532TIL15 6/1/2015 6/1/2016 X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ Uninsured motorist combined $ 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10, 000, 000 C, EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ X DTSMCUP4794N532TIL15 /1/2015 6/1/2016 D WORKERS COMPENSATION y X WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N E.L. EACH ACCIDENT $ 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE [Nq] N / A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) 4029651 6/1/2015 6/1/2016 E.L. DISEASE - EA EMPLOYE $ SOO, OOO If yes, describe under E.L. DISEASE - POLICY LIMIT I $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: 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. a,F-n I rrra,#A r F_ nvL_UF_n L AIVI,tLLA I IUIV 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 AGUHU 25 (2010/05) INS025 (201005).01 Mosbrucker CIC,CISR © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD A� " CERTIFICATE OF LIABILITY INSURANCE 5/ E(.WDD 5 Y) 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 and Peterson PO Box 578 Greeley CO 80632 CONTACT Nikki Mosbrucker CIC, CISR NAME: PHONE (970)266-7123FAX Noll: (970)506-6823 E-MAIL NMosbrucker@floodpeterson.com INSURERS AFFORDING COVERAGE NAIC If INSURERA:Charter Oak Fire Insurance 25615 INSURED Connell Resources, Inc. 7785 Highland Meadows Parkway #100 Fort Collins CO 80528 INSURERB:Travelers Indemnity Company 25658 INSURERC:Travelers Property Casualty 25674 INSURERD:Pinnacol Assurance 1190 INSURER E : INSURER COVERAGES CERTIFICATE NUMBER:CL1552803110 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 ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE aOCCUR X DTC04794N532COF15 6/1/2015 6/1/2016 DAMAGE To RENTE PREMISES E.occurence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X DT8104794N532TIL15 6/1/2015 6/1/2016 BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOSAUTOS N Uninsured motorist combined $ 1,000,000 X UMBRELLA LAB X OCCUR EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10, 000, 000 C EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ X DTSMCUP4794N532TIL15 /1/2015 6/1/2016 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N❑ (Mandatory in NH) N / A y 029651 6/1/2015 6/1/2016 X WC STIMIT OTH- E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYE9 $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Contractors Right of Way License Certificate holder is named as additional insured, but only as respects liability arising out of work performed by the named insured (Excluding Workers' Compensation). L,r-H I IrIL A I t MULUtti I;;ANt;tLLA I IUN City of Fort Collins Engineering Dept. 281 North College Ave 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 Mosbrucker CIC,CISR ACORD 25 (2010/05) INS025 (201005).01 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD . *.O� CERTIFICATE OF LIABILITY INSURANCE D 2015/DD 5/28/28/ 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 CIC, CISR NAME: Flood and Peterson PO Box 578 PHOAIC.NE (970)266-7123 FAX tAC.No (970)506-6823 E-MAIL-NMosbrucker@floodpeterson.com ADHESS INSURERS AFFORDING COVERAGE NAIC # Greeley CO 80632 INSURERA:Charter Oak Fire Insurance 25615 INSURED INSURERB:Travelers Indemnity Company 25658 Connell Resources, Inc. INSURERC:Travelers Property Casualty 25674 7785 Highland Meadows Parkway #100 INSURERD:Pinnacol Assurance 1190 INSURER E : Fort Collins CO 80528 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1552803110 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 ADDL SUBR POLICY NUMBER POLICY EFF MM/DDNYYY POLICY EXP MM/ DNVYV LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 X COMMERCIAL GENERAL LIABILITY DAMA= RENTPREMISES Ea occurrence $ 300, 000 A CLAIMS -MADE OCCUR X TC04794N532COF15 6/1/2015 6/1/2016 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO- JECTLOC $ AUTOMOBILE LIABILITY MINED SINGLE LIMIT 1,000,000 X _(Ea BODILY INJURY (Per person) $ B ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS X DT8104794N532TIL15 6/1/2015 /1/2016 NON -OWNED HIRED AUTOS N AUTOS X PROPERTY DAMAGE Per accident $ Uninsured motorist combined $ 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10,000,000 C, EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ X DTSMCUP4794N532TIL15 6/1/2015 6/1/2016 D WORKERS COMPENSATION g X I WC STATUS OTH- FR AND EMPLOYERS' LIABILITY Y / NOR, E.L. EACH ACCIDENT $ 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? F N/A E.L. DISEASE - EA EMPLOYEE $ 500,000 (Mandatory in NH) 4029651 6/1/2015 6/1/2016 If yes, describe under E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) RE: CRI# 2141052 - East Community Park Site Earthwork Project 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. 1 r � r _Ww n I.ANUrLLA I IUN 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 AI.UFIU Zb (ZVIU/Ub) INS025 (201005).01 Mosbrucker CIC,CISR © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD '``�� �� CERTIFICATE OF LIABILITY INSURANCE 5/28/2015YY' 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 CIC, CISR NAME: Flood and Peterson PO Box 578 PHONE (970)266-7123 FAX (970)506-6823 C No: E-MAIL NMosbruckerQfloodpeterson.com ADDRESS INSURERS AFFORDING COVERAGE NAIC # Greeley CO 80632 INSURER A:Charter Oak Fire Insurance 25615 INSURED INSURERB:Travelers Inderrmity Company 25658 Connell Resources, Inc. INSURERC:Travelers Property Casualty 25674 INSURERD:Pinnacol Assurance 7785 Highland Meadows Parkway #100 4190 ---::: INSURER E Fort Collins CO 80528 INSURERF: , COVERAGES CERTIFICATE NUMBER:CL1552803110 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 ADDL Jul& SUBR WVD POLICY NUMBER POLICY EFF MM/DDNYYV POLICY EXP MM/DDNVYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 A CLAIMS -MADE 7 OCCUR X DTC04794N532COF15 6/1/2015 6/1/2016 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea .".ntl $ 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS X DT8104794N532TIL15 /1/2015 6/1/2016 HIRED AUTOS X NON -OWNED AUTOS X PROPERTY DAMAGE Per accident $ Uninsured motorist combined $ 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10,000,000 C, EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ X DTSMCUP4794N532TIL15 6/1/2015 6/1/2016 D WORKERS COMPENSATION y X I WC STATUS OTH- ER AND EMPLOYERS' LIABILITY Y / NI E.L. EACH ACCIDENT $ 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N/A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) 4029651 6/1/2015 6/1/2016 E.L. DISEASE - EA EMPLOYEE $ 500,000 If yes, describe under E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: CRI # 2141084; 8035 Arthur Ditch Bridge Replacement- Canyon Avenue 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. a,F-n r rrn,rn i C nvLvF_n 11,ANL rLLA 1 IUN City of Fort Collins 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. AUTHORIZED REPRESENTATIVE A(;UKL) 25 (2010/U5) INS025 (201005).01 Mosbrucker CIC,CISR © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD A� " CERTIFICATE OF LIABILITY INSURANCE Y 5/28/20/15 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 and Peterson PO Box 578 Greeley CO 80632 CONTACT Nikki Mosbrucker CIC, CISR NAME: PHONEN. (970) 266-7123 AX No: (970)506-6823 EAI -ML .NMosbruckerQfloodpeterson.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:Charter Oak Fire Insurance 25615 INSURED Connell Resources, Inc. 7785 Highland Meadows Parkway #100 Fort Collins CO 80528 INSURERB:Travelers Indenmity Company 25658 INSURERC:Travelers Property Casualty 25674 INSURERD:Pinnacol Assurance 1190 INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER:CL1552803110 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 ADDL SUBR POLICY NUMBER POLICY EFF MM/DDNYVY POLICY EXP MM/DDNYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FXI OCCUR X DTC04794N532COF15 6/1/2015 6/1/2016 DAMAGE TO R7N77ff-- PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X T8104794N532TIL15 6/1/2015 6/1/2016 BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ X NON -OWNED HIRED AUTOS AUTOS Uninsured motorist combined $ 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10, 000, 000 C EXCESS LIAR CLAIMS -MADE DED RETENTION$ $ X DTSMCUP4794N532TIL15 6/1/2015 6/1/2016 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N Y X WC STATU- OTH- E.L. EACH ACCIDENT $ 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A 029651 6/1/2015 6/1/2016 E.L. DISEASE - EA EMPLOYEE $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below 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# 2151026; 1st Street Improvements 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. GtH I IrIUA I t MULUtH City of Fort Collins 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. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) INS025 (201005).01 Mosbrucker CIC, CISR ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORN® � CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 5/28/2015 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 and Peterson PO Box 578 Greeley CO 80632 CONTACT Nikki Mosbrucker CIC, CISR NAME: PHONE (970) 266-7123 AX N : (970)506-6823 E-MARIL NMosbrucker@floodpeterson.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:Charter Oak Fire Insurance 25615 INSURED Connell Resources, Inc. 7785 Highland Meadows Parkway #100 Fort Collins CO 80528 INSURERB:Travelers Indemnity Company 25658 INSURERC:Travelers Property Casualty 25674 INSURERD:Pinnacol Assurance 1190 INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER:CL1552803110 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 ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X DTC04794N532COF15 6/1/2015 6/1/2016 DAMAGE TO RENTrU- PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X T8104794N532TIL15 6/1/2015 6/1/2016 BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS X AUTOS Uninsured motorist combined $ 1 000 000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10, 000, 000 C, EXCESS LIAB CLAIMS -MADE DED I RETENTION$ $ X DTSMCUP4794NS32TIL15 6/1/2015 6/1/2016 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N❑ (Mandatory in NH) N / A Y 029651 6/1/2015 6/1/2016 X WC STATU- OTH- RY TO ITS IE R E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYE $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below 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 # 2141076; Boxelder Creek Widening 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. CERTIFICATE HOLDER CANCELLATION City of Fort Collins 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. AUTHORIZED REPRESENTATIVE Mosbrucker CIC, CISR ACORD 25 (2010/05) INS025 (2011305).01 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACCOR " CERTIFICATE OF LIABILITY INSURANCE1 F DATE (MWDDNYY 5/28/2015 Y) 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 and Peterson PO Box 578 Greeley CO 80632 CONTACT Nikki Mosbrucker CIC, CISR NAME: PHONE (970) 266-7123 NX N (970)506-6823 EAI -ML NMosbrucker@floodpeterson.com INSURERS AFFORDING COVERAGE NAIC a INSURERA:Charter Oak Fire Insurance 25615 INSURED Connell Resources, Inc. 7785 Highland Meadows Parkway #100 Fort Collins CO 80528 INSURERB:Travelers Indemnity Company 25658 INSURERC:Travelers Property Casualty 25674 INSURERD:Pinnacol Assurance 41190 INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER:CL1552803110 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 ADDL UBR POLICY NUMBER POLICY EFF MM/DDNYYV POLICY EXP MM/DDNYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE aOCCUR X DTC04794N532COF15 6/1/2015 6/1/2016 DAMAGE TO RENTEI� PREMISES Ea occurrence) $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X T8104794N532TIL15 6/1/2015 6/1/2016 BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS N AUTOS Uninsured motorist combined $ 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10, 000, 000 C EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ X DTSMCUP4794N532TIL15 6/1/2015 6/1/2016 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / NLJMTl ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) N/A y 029651 6/1/2015 6/1/2016 X I WC STATU- OTH- I ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below 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# 2141062 - West Vine Outfall -- Landscaping 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. Gtli I It-IGA I t HULUtN GANGtLLAT1UN 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 (2010/05) INS025 (201005).01 Mosbrucker CIC,CISR ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD A� & CERTIFICATE OF LIABILITY INSURANCE DATE (MWDDfYYY 5/28/2015 Y) 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 and Peterson PO Box 578 Greeley CO 80632 CONTACT Nikki Mosbrucker CIC, CISR NAME: PHONE (970) 266-7123 FAX N (970)506-6823 E-MAIL NMosbruckerQfloodpeterson.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:Charter Oak Fire Insurance 25615 INSURED Connell Resources, Inc. 7785 Highland Meadows Parkway #100 Fort Collins CO 80528 INSURERB:Travelers Indemnity Company 25658 INSURERC:Travelers Property Casualty 25674 INSURERD:Pinnacol Assurance 41190 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:CL1552803110 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 ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X DTC04794N532COF15 6/1/2015 6/1/2016 DAMA TZ REN PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 71 POLICY X PRO LOC I $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X T8104794N532TIL15 6/1/2015 6/1/2016 BODILY INJURY (Per accident) $ HIRED AUTOS X NON -OWNED AUTOS X PROPERTY DAMAGE Per accident $ 1Ininsuredmotor istcombined $ 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10, 000, 000 C, EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ X DTSMCUP4794N532TIL15 6/1/2015 6/1/2016 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under N / A i 4029651 6/1/2015 6/1/2016 X WC STATU- OTH- E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE- EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS! LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: CRI# 2141003 - Rigden Water Storage Reservoir Earthwork - WO# CR-RWSR-2014-2 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 LLLA I IUN 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 AL;UKU Z5 (ZUIU/U5) INS025 (201005).01 N Mosbrucker CIC,CISR © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD