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GENERAL32633
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GENERAL32633
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Last modified
8/24/2016 7:55:04 PM
Creation date
11/23/2007 7:22:25 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981034
IBM Index Class Name
General Documents
Doc Date
5/12/1995
Doc Name
CERTIFICATE OF INSURANCE
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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AIDIII:11. CERTIFICATE OF INSURANCE CSR JN °ATE IMM,°°/YY, <br />SHMCO-1 05/10/95 <br />PaooucER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />y <br />1111111 III <br />~ <br />e <br />on <br />AT <br />Inc. II I I III II <br />p <br />O <br />R <br />O <br />p <br />E <br />G <br />0 <br />L <br />TER <br />THE COVERAGE <br />ORDED B <br />Y THE PO <br />L LIES <br />BE OW. <br />P O <br />Box <br />6 <br />30 <br />Grand Junction CO 81506 <br />COMPANIES AFFORDING COVERAGE <br />L/~I~' r <br />Janet Nell ,~L~l~f~-~I,~I ~'~/ COMPANY <br />970-245-8011 A Employers Mutual Casualty Co. <br />INSURED MAY 12 1995 COMPANY <br /> B <br />SHM Construction CO. ~ <br />Di <br />i <br />i COMPANY <br />v <br />s <br />on Gt Minerals ~, uealo <br />MINRHC, Inc. (ATIMA) ~ <br />773 Valley COllrt <br /> <br />Grand Junction CO 81505 COMPANY <br />p <br />COVERAGES <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED, NOTWITHSTANDING ANV REQUIREMENT, TERM OR CONDITION OF ANV CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAV BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />E%CLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />CD <br />LTR TYPE OF INBUIIANCE POLICY NUMBER POLICY EFFECTIVE POLICY E%PIaAT10N LIMBS <br /> DATE IMM/DDPIYI DATE IMM/DD/YYI <br /> GEN ERAL LIABILITY GENERAL AGGREGATE l2, OOO, GDD <br />A X COMMERCIAL GENERAL LIABILITY 9X9086896 05/10/95 05/10/96 PRODUCTS~COMP/OP AGG l2, OOO, GDG <br /> CLAIMS MADE ^X OCCUa PERSONALS ADV INJURY S1, DGD, GDG <br /> OWNER'SNCONTRACTOa'S PROT EACH OCCURRENCE l1, DDD, GGD <br /> FIRE DAMAGE IAny one lire) ! ~JD, DDG <br /> MED EXP IAny one Personl ! 5, DGG <br /> AUT OMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />l1, DDD, DGD <br />A X ANY AUTO 9X9086896 05/10/95 05/10/96 <br /> ALL OWNED AUTOS <br />BODILY INJURY <br />! <br /> SCHEDULED AUTOS IPer person) <br /> X HIRED AUTOS <br />BODILY INJURY <br />! <br /> ~( NON~OWNED AUTOS IPer acciGenU <br /> <br /> PROPERTY DAMAGE ! <br /> GARAGE DABILRY AUTO ONLY ~ EA ACCIDENT ! <br /> ANY AUTO OTHER THAN AUTO ONLY: <br /> EACH ACCIDENT S <br /> AGGREGATE i <br /> E%CE55 lIABILITY EACH OCCURRENCE ! <br /> UMBRELLA FORM AGGREGATE ! <br /> OTHER THAN UMBRELLA FORM ! <br /> WORlERS COMPENSATION AND STATUTORY LIA11T5 <br /> EMPLOYERS' LIABILITY <br />EACH ACCIDENT <br />S <br /> THE PROPRIETOR/ INCL DISEASE-POLICY LIMIT ! <br /> PARTNERS/EXECUTIVE <br /> OFFICERS ARE: E%CL DISEASE~EACH EMPLOYEE S <br /> OTHER <br />DESCRIPTION OF OPERATIONSILOCATIONS/VEHIClES/SPECIAL REMS <br />ALL OPERATIONS/ALL LOCATIONS <br />RH: RHD CANYON MINH - FILM NO. C-B1-034 <br />ADDITIONAL INSURED: STATH OF COLORADO, DIVISION OF MINERALS AND GEOLOGY <br />CERTIFICATE HOLDER CANCELLATION <br />COLOMIN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIMTION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOa TO MAIL <br />$tatB OE COl OradO 3O DAYS WRIREN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. <br />Division of Minerals & GElOlOCJy <br /> <br />1313 Sherman Street, Room 215 BUT FAILURE TO MAIL SUCH NOTICE SMALL IMPOSE NO OBLIGATION Oa LIABILfTY <br />Denver CO 80203 OF ANY HIND UPON THE Y, ITS AGENTS OR REPRESENTATIVES. <br /> AUTHORISED aEPaES ATIVE <br /> Janet Neil <br />ACORD 25-5 (3/93) mACO D CORPORATION 7993 <br />
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