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Home My WebLink About109445 CONNELL RESOURCES INC - INSURANCE CERTIFICATE (90)75T (MM/DD/YYYY) AR" CERTIFICATE OF LIABILITY INSURANCE 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 NAME: Dana Stewart, CIC, CISR Flood and Peterson PHONE a E (970)266-7149 Nu: (970)506-6845 PO Box 578 ADDRESS.DStewart@floodpeterson.con, INSURERS AFFORDING COVERAGE NAIC # Greeley CO 80632 INSURERA:Charter Oak Fire Insurance Company 25615 INSURED INSURERB:Travelers Indemnity Company 25658 Connell Resources, Inc. INSURERc:Travelers Property Casualty Company 25674 7785 Highland Meadows Parkway INSURERD:Pinnacol Assurance 41190 Suite 100 INSURERE: _ Fort Collins CO 80528 INSURERF: rnuGoer_1=c CFRTIFIRATF NIIMRFR•2017 GL/AU/XS/WC RFVISInN NIIMRFR- 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 SUBRWyD POLICY NUMBER POLICY IDDY EFF MOLT DY EXP LTR YYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE X OCCUR 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 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JECT 7 LOC PRODUCTS - COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ B X ANY AUTO ALL OSCHEDULED AUUTOSS AUTOS DT8104794N532IND17 6/1/2017 6/1/2018 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED X HIRED AUTOS X AUTOS _ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 101000, 000 C EXCESS LIAB CLAIMS -MADE DED I X RETENTION 10,000 $ 1 CUP4J906749-17-26 6/1/2017 6/1/2018 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A 4029651 6/1/2017 6/1/2018 X STATUTE ERH E.L. EACH ACCIDENT $ 500, 000 E.L. DISEASE- EA EMPLOYE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: CRI# 2171001 - McMurry Bridge Repair Certificate holder is included as Additional Insured on General liability and Automobile liability 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 Purchasing Department PO Box 580 Fort Collins, CO 80524 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 Stewart, CIC, CISR/ (-77 u d __- ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 (201401)