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HomeMy WebLinkAbout109445 CONNELL RESOURCES INC - INSURANCE CERTIFICATE (93)ACORO® DATE (MNI/DD/YYYY) 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 PHONN (970) 266-7149 No: (970)506-6845 PO Box 578 ADDRESS: DStewartftloodpeterson. com INSURER(S) AFFORDING COVERAGE NAIC N Greeley CO 80632 INSURED Connell Resources, Inc. 7785 Highland Meadows Parkway Suite 100 INSURERA:Charter Oak Fire INSURERB:Travelers Indem i INSURERD:Pinnacol Assurance INSURER E : J Fort Collins CO 80528 1 INSURERF: COVERAGES CERTIFICATE NUMRER:2017 GL/AU/XS/WC REVISION NUMRFR- 25658 25674 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. INSIR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMBS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 A CLAIMS -MADE X OCCUR __ DAMAGE TO RENTED PREMISES Ea occurrence $ 300, 000 MED EXP (Any one person) $ 10,000 Y DTC04794N532COF17 6/1/2017 6/l/2018 PERSONAL & ADV INJURY $ 11000,000 GEN'L GENERAL AGGREGATE $ 2,000,000 AGGREGATE LIMIT APPLIES PER: X POLICY � JECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED IN IT IMI Ea accident $ 11000,000 X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS Y DT8104794N532IND17 6/1/2017 6/1/2018 BODILY INJURY (Per accident ) $ X X NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10, 000, 000 C EXCESS LIAB CLAIMS -MADE DED I X I RETENTION 10,000 $ Y CDP4J906749-17-26 6/1/2017 6/1/2018 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER (Mandatory in NHR EXCLUDED? a H yes, describe under DESCRIPTION OF OPERATIONS below N/A Y 4029651 6/1/2017 6/1/2018 X PER TH- 'STATUTE ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYE $ 5001000 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: 8310 Aggregate 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. IL" aaIIaLr1L11:1: Lei 4aJa:1 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 �7 - - Stewart, CIC, CISR/ L7-" ACORD 25 (2014/01) INS025 (201401) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD