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Home My WebLink About109445 CONNELL RESOURCES INC - INSURANCE CERTIFICATE (71)ACCORLIP CERTIFICATE OF LIABILITY INSURANCE DATE OS/31/2018 Y) 31l2018 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 have ADDITIONAL INSURED provisions or 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 Dana Stewart, CIC, CISR NAME: Flood and Peterson PHONE Ext : (970) 266-7149 AJC, No : (970) 506-6845 E-MAIL DStewart@floodpeterson.com ADDRESS: PO Box 578 INSURER(S) AFFORDING COVERAGE NAIL # INSURER A: Charter Oak Fire Insurance Company 25615 Greeley CO 80632 INSURED INSURER B : Travelers Indemnity Company 25658 INSURER c : Travelers Property Casualty Company of America 25674 Connell Resources, Inc. 7785 Highland Meadows Parkway INSURER D : Pinnacol Assurance 41190 INSURER E : Suite 100 INSURER F : Fort Collins CO 80528 cnVFRAGFS CERTIFICATE NUMBER_ GL/AUIXS/WC x6/2019 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 ADDL5UBR INSD WVD POLICY NUMBER POLICY EFF MMIDD POLICY EXP MMIDDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1.000,000 CLAIMS -MADE ® OCCUR DAMAGE TO RENTEU- PREMISES Ea occurrence 300,000 $ MED EXP (Any one person) $ 10,000 A DT-CO-4794N532-COF-I8 06/01/2018 06/01/2019 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2.000,000 POLICY PRO- ❑ LOC JEC7 PRODUCTS -COMPIOPAGG S 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT �Ea accdent $ 1,000,000 BODILY INJURY (Per person) S ANY AUTO B OWNED SCHEDULED AUTOS ONLY AUTOS DT-810-4794N532-IND-18 06/01/2018 06/01/2019 BODILY INJURY (Pe raccident) $ PROPERTY DAMAGE Per accident S HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE S 1,000,000 C EXCESS LIAB CLAIMS -MADE CUP4J906749-18-26 06/01/2018 06/01/2019 DED I X RETENTION $ 10,000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY v / N ANY EMBEL'PARTNERlEXECUTIVE OFFICER;MEMBER EXCLUDED? (Mandatory In NH) NIA 4029651 06/01/2018 06/01/2019 PER OTH- STATUTE ER E.L.BACHAccIOENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500.000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $00,000 $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) RE: 8484 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) per written contract. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins Purchasing Division ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins CO 80522 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD