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HomeMy WebLinkAbout109445 CONNELL RESOURCES INC - INSURANCE CERTIFICATE (88)AC" ® DATE (MWDDNYYY) �� 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 coNTA Dana Stewart, CIC, CISR NAME: Flood and Peterson PNCNNc E : (970) 266-7149 FAX No: (970)506-6845 PO Box 578 E-MAIL SS. DStewart@floodpeterson.com INSURERS AFFORDING COVERAGE NAIC • Greeley CO 80632 INSURERA:Charter Oak Fire Insurance Company 25615 INSURED INSURER B:Travelers Indemnity Company 25658 Connell Resources, Inc. INSURERC:Travelers Property Casualty Company 25674 7785 Highland Meadows Parkway INSURERD:Pinnacol Assurance 41190 Suite 100 INSURER E.- -Fort Fort Collins CO 80528 INSURERF: CnVFRAGFS CFRTIFIrATF NIIMRFR•2017 GL/AU/XS/WC DGvtClnki Kit eRaDCD• 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 SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER p/y LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) DTC04794N532COP17 6/1/2017 6/1/2018 $ 10,000 PERSONAL & ADV INJURY $ 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY CJ ECTT LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OPAGG $ 2,000,000 $ 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 BODILY INJURY Per accident RY ( ) $ NON -OWNED HIRED AUTOS X AUTOS X PROPERTY DAMAGE Peracc,deM $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10, 000, 000 C EXCESS LIAB CLAIMS -MADE DIEDX RETENTION 10 000 $ CUP4J906749-17-26 6/1/2017 6/1/2018 D WORKERS COMPENSATION AND EMPLO ERS' LIABILIITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE (Mandatory andaory in NH EXCLUDED? ( rY ) If yes, describe under DESCRIPTION OF OPERATIONS below N/A Y 4029651 6/1/2017 6/1/2018 X STAUTE ERH E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: CRI# 2161006 - 7622 Integrated Recycling Facility 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. 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 D Stewart, CIC, CISR/ _ ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)