2015-11-09_GENERAL DOCUMENTS - C1981028

Home Browse Search

ACORD,CERTIFICATE OF LIABILITY INSURANCE 11/1/2016 DATE(MM/DD/YYYY) 10/� 0/2015 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 Lockton Companies 8110 E Union Avenue Suite 700 Denver CO 80237 (303) 414-6000 CONTACT NAME: AIC No Ext): A/C No): E-MAIL ADDRE S S: IN RER S AFFORDING COVERAGE NAIC # INSURER A: ACE American Insurance ComiDany 22667 INSURED Molson Coors Brewing Company 1030130 Coors Energy Company 1801 California Street, Suite 4700 Denver, CO 80202 INSURER B: INSURER C : INSURER D: INSURER : INSURER : COVERAGES MOLC001 CERTIFICATE NUMBER: 1439971 REVISION NUMBER: XXXXXXX 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 ADDL IN D SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY N N OGLG25700983 11/1/2015 11/1/2016 EACH OCCURRENCE 2,000,000 DAMAGE TO RENTED XXXXXXX PREMISES Ea occurrence CLAIMS -MADE OCCUR MED EXP (Any oneperson) 5,000 X Vendors X $100-000 SIR PERSONAL 8 ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY JE� F—] LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER A AUTOMOBILE LIABILITY N N CALH08610319 11/1/2015 11/1/2016 COMBINED SINGLE LIMIT Ea accldent $ 2 000 000 BODILY INJURY (Per person) $ XXXXXXX X ANY AUTO AUTOWNED SCHEDULED AUTOS BODILY INJURY (Per accident $ XXXXXXX PROPERTY DAMAGE $XXXXXXX Per accldent NON OWNED X HIRED AUTOS X AUTOS $XXXXXXX UMBRELLA LIAR OCCUR EACH OCCURRENCE $ XXXXXXX EXCESS LIAB CLAIMS -MADE NOT APPLICABLE AGGREGATE $ XXXXXXX DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? IMandatory In NH) N / A NOT APPLICABLE PER OTH- STATUTE FIR E L EACH ACCIDENT $ XXXXXXX E L DISEASE - EA EMPLOYEE XXXXXXX u yes. de ulbc „c�� DESCRIPTION OF OPERATIONS below _ L DISEPeE _ -1 IrY LIMIT A XXXXXXX DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101WIllop marks Schedule, may be attached if more space is required) RE: Keenesburg Mine. NOv g Jp1s R& Sa{ kl Qn, %sV1 n n9 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1439971 AUTHORIZED REPRESENTATIVE Colorado Division of Reclamation Mining and Safety 1313 Sherman Street, Room #215 Denver CO 80203 ACORD 25 (2014/01) ©10812014 ACORD CORPOKATION. All rights reserved Tho Ar.r1R11 n�mo onrl Innn oro ronicfororl marlre of Ar`r1R1'1