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GENERAL32779
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GENERAL32779
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Last modified
8/24/2016 7:55:08 PM
Creation date
11/23/2007 7:26:01 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981035
IBM Index Class Name
General Documents
Doc Date
4/28/2006
Doc Name
Certificate of Insurance
Permit Index Doc Type
Insurance
Media Type
D
Archive
No
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<br />' DATE(MM/DD/YYYY) <br />A60RD,~ LIABItiITY:INSIJRANGE ~ oa/za/zoo6 <br />.CERTIFICATE OT <br />PRODUCER <br />AOn Rl sk se rVl CeS of Te%dS,IDC THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY <br />1330 Post Oak Blvd. AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS <br />Suite 900 CERTIFICATE DOES NOTAMEND,EXPEND OR ALTER THE <br />Houston TX 77056-3089 USA COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> INSURERS AFFORDING COVERAGE NAIC # <br />eHONE. 866 283-7124 FAx. 866 <br />wsuRED IrvsuRER A: Westchester Fire insurance co 21121 <br />National King Coal, LLC wsuRERS: National union Fire Ins co of Pittsburgh 19445 <br />4424 County Road 120 <br />20U6 <br /> <br />Hesperus co 81326 USA <br />APR 2 8 <br />INSURER C: <br /> <br /> INSURER D: <br />Division of Minerals h G <br /> wsuRER E: <br />COVERAGES= .'.. -. ; .~ :- .-SIRi Ma A <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUBiEMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W ITN RESPECT TO WHICH THIS CERTIFICATE MAY BE LSSUED OR MAY <br />PERTAIIJ, THE INSURANCE AFFORDED BY THE POLICES DESCRIBED HEREw IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. <br />AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />wSR <br />LTR AD <br />w5 <br />TYPE OF wSURANCE <br />POLICY NUMBER POLICY EFFECTI POLICY EXPIRATION <br />LN1ITS <br /> DATE(MMIDD\YY) DATE(MMIDIAYY) <br />e GL0714135 04/13/06 09/01/06 EACH OCCURRENCE $1 <br />000 <br />000 <br /> ENERAL LUanITr <br />. , <br />, <br />__ ._~ X _ .. -,.-_. <br />COMMERCIAL GENERAL LIABILITY __... __ _ ..._ __ __ <br />~ _ <br />DAMAGE TO RENTED __ __ <br />- ~ $50,000 <br /> PREMISES (Ea occurevce) <br /> CLAIMS MAD6 ® OCCUR ( V OM p[r5pa) <br /> PERSONAL&ADV IWURY $1,000,000 <br /> GENERAL AGGREGATE $2,000,000 <br /> <br /> GENL AGGREGATE LIMB APPLIES PER: <br />PRODUCfs-COMP/OP AGG <br />$2,000,000 <br /> ^X POLICY ^ <br />^ LOC ' <br /> JECI <br />B AUT OMOBILE LIABR.TTY CA 720-50-56 04/13/06 09/01/06 COMBINED SINGLE LIMIT <br /> % ANY AOTO (Ea amidenr) 51,000,000 <br /> ALL OWNED AUTOS <br />BODB.Y INIURV <br /> SCHEDULED AUTOS (Per persov) <br /> X HDiED AUTOS <br />BODB.Y INIURY <br /> NON OWNED AUTOS (Per accde,uJ <br /> $1000 Comp Ded PROPERTY DAMAGE <br /> i <br />P <br /> 51000 Coll Ded er xce <br />( <br />coc) <br /> GARAGE LIABILTTY AUTOONLY- EA ACCIDENT <br /> ANY AUTO <br />OTHER THAN EA ACC <br /> B AUTO ONLY <br /> AGG <br />A EXC ESS AIMBRELLA UAHILrPY 621985661001 09/01/05 0 EACH OCCURRENCE <br /> OCCUR CLAIMS MADE AGGREGATE $10,000,000 <br /> <br /> DEDUCTIBLE <br /> <br /> RETENTION $10,000 <br />B WC % WC STAN- ON- <br /> WORKERS COMPENSATION AND IMR ER <br /> EMPLOYERS'LIABII,ITY E.L EACH ACCIDENT S1, 000, 000 <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />RL DISEASE-EA EMPLOYEE <br />$1, 000, 000 <br /> If yes, deunbe uvder SPECIAL PROVISIONS E.L DISEASE-POLICY LIMIT $1,000,000 <br /> beWw <br /> OTHER <br />DESCRB'TION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />see Attached: <br />CERTIFICA7`EHOLD R ~' -':- CANCELLATION = "'°_ ~~°` .: ~~-~=~``~ <br />Dl Vl sl00 of Minerals and Geology sHOULD ANY OFTHE ABOVE DESCRIBED POUCHS BE CANCELLED BEFORE NEEXPBtATION <br />1313 Sherman street, Room 215 DATE THEREOF,IHE ISSUING INSURER WILL ENDEAVOR TO MAIL <br />Denver CO 50203 usA 30 DAYS WRITTEN NOTICE TO THE CERI]FICATE HOLDER NAMED TO THE LEFT, <br /> BUT FAILURE TO DO 50 SHALL IMPOSE NOOBLIGATION OR LIABILITY <br /> OF ANY KIND UPON THE INSURER. ITS AGEMS OR REPRESENTATIVES. <br /> AUNORIZED REPRESENTATIVE <br />laSaae 'r~'a~ .iezewCCd e6 `~exctd. 7.,rG. <br /> <br />Y <br />N <br />w <br />.c <br />.. <br />Y <br />x` <br />N <br />N <br />m <br />v <br />O <br />O <br />N <br />O <br />z <br />d <br />4' <br />W <br />U <br />La <br /> <br />
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