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2016-08-29_PERMIT FILE - C1981035A (46)
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2016-08-29_PERMIT FILE - C1981035A (46)
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Last modified
10/5/2023 9:50:26 AM
Creation date
10/20/2016 10:08:23 AM
Metadata
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Template:
DRMS Permit Index
Permit No
C1981035A
IBM Index Class Name
Permit File
Doc Date
8/29/2016
Section_Exhibit Name
KII Appendix 14 Certificate of Liability Insurance
Media Type
D
Archive
Yes
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0 <br />Notification to Others of Cancellation, Nonrenewal or ZURICH <br />Reduction of Insurance <br />Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer No. Add'I. Prem Return Prem. <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />This endorsement modifies insurance provided under the: <br />Commercial General Liability Coverage Part <br />Liquor Liability Coverage Part <br />Products/Completed Operations Liability Coverage Part <br />A If we cancel or non -renew this Coverage Part(s) by written notice to the first Named Insured for any reason other than <br />nonpayment of premium, we will mail or deliver a copy of such written notice of cancellation or non -renewal: <br />1. To the name and address corresponding to each person or organization shown in the Schedule below; and <br />2. At least 10 days prior to the effective date of the cancellation or non -renewal, as advised in our notice to the first <br />Named Insured, or the longer number of days notice if indicated in the Schedule below. <br />B. If we cancel this Coverage Part(s) by written notice to the first Named Insured for nonpayment of premium, we will <br />mail or deliver a copy of such written notice of cancellation to the name and address corresponding to each person or <br />organization shown in the Schedule below at least 10 days prior to the effective date of such cancellation. <br />C. If coverage afforded by this Coverage Part(s) is reduced or restricted, except for any reduction of Limits of Insurance <br />due to payment of claims, we will mail or deliver notice of such reduction or restriction: <br />1. To the name and address corresponding to each person or organization shown in the Schedule below; and <br />2. At least 10 days prior to the effective date of the reduction or restriction, or the longer number of days notice if <br />indicated in the Schedule below. <br />D. If notice as described in Paragraphs A, B. or C. of this endorsement is mailed, proof of mailing will be sufficient proof <br />of such notice. <br />SCHEDULE <br />Name and Address of Other Person(s) / Organ¢ation(s): <br />Number of <br />Days Notice: <br />OFFICE OF SURFACE MINING RECLAMATION <br />30 <br />AND ENFORCEMENT, WESTERN REGION <br />1999 BROADWAY, SUITE 3320 <br />DENVER, CO 80202— 3050 <br />All other terms and conditions of this policy remain unchanged. <br />U -GL -1447-A CW (05/ 10) <br />Page 1of1 <br />Includes copyrighted material of Insurance Services Office, Inc., with its permission. <br />
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