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HomeMy WebLinkAbout109445 CONNELL RESOURCES INC - INSURANCE CERTIFICATE (83)AC� ® DATE (MM/DDNYYY) CERTIFICATE OF LIABILITY INSURANCE F5/30/2017 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 Dana Stewart, CIC, CISR NAME: Flood and Peterson PHONrE E (970)266-7149 �: (970)506-6845 PO BOX 578 ADDRESS: DStewartlillfloodpeterson.com INSURER(S) AFFORDING COVERAGE NAIC • Greeley CO 80632 INSURED Connell Resources, Inc. 7785 Highland Meadows Parkway Suite 100 Fort Collins CO 80528 INSURERA:Charter Oak Fire Insurance Company 25615 INSURERB:TraVelers Indemnity Company 25658 INSURERC:TraVelers Property Casualty Company 25674 INSURERD:Pinnacol Assurance INSURER E : INSURERF: 41190 COVERAGES CFRTIFICATF NIIMRFR•2017 GL/AU/XS/WC RFVICIr)M MIImpro- 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 ADDL SUER POLICY EFF POLICY EXP LTR POLICY NUMBER (MMA)DrfYYYI (MM/DDNYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR EACH OCCURRENCE $ 11000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 DTC04794N532COF17 6/1/2017 6/1/2018 PERSONAL & ADV INJURY $ 1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY PRO - II JEa LOC GENERAL AGGREGATE $ 2,000,000 - COMP/OP AGG $ 2,000,000 -PRODUCTS $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 11000,000 X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS DT8104794N532IND17 6/1/2017 6/1/2018 P BODILY INJURY (Per accident ( ) $ NON -OWNED HIRED AUTOS X AUTOS X PROPERTY DAMAGE Per accident $ $ X UMBRELLA LIAS X OCCUR EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10,000,000 CPDED XCESS LIAB CLAIMS -MADE T6/1/2017 X RETENTION$ 10,000 $ COP4J906749-17-26 6/1/2018 D WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 4029651 6/1/2017 6/1/2018 X PER O H- STATUTE ER E.L. EACH ACCIDENT $ 500,000 E.LDISEASE- EAEMPLOYE $ 500,000 E.L. DISEASE - POLICY LIMIT I $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: CRI# 2161084 - Robert Benson Lateral Repair 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. %,crs 1 IrFt,A 1 c rIULLIrrs I;ANGtLLA I IUN City of Fort Collins 215 N Mason St 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 (2014/01) INS025 (201401) D Stewart, CIC, CISR/ - ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD