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GENERAL33387
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GENERAL33387
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Last modified
8/24/2016 7:55:23 PM
Creation date
11/23/2007 7:37:19 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981022
IBM Index Class Name
General Documents
Doc Date
9/16/2004
Doc Name
Certificate of Liability Insurance
Permit Index Doc Type
Insurance
Media Type
D
Archive
No
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c_~ <br />'- <br />_ ~ : <br />_, a i <br />'~~ ~-. <br />.. .. _a DATE (MM~DD~ri) t <br />/~// <br />p <br />T/^1. <br />+ T <br />r ~ <br />7cT~ y~~+_ <br />s~°"+--~~( ~9~1~~~4 <br />C'~~~Ba~,~~ <br />"? /'f1tIOI~D,x V~SL~~1L~~~~ <br />1L14741LL7~'~~ <br />~~ <br />`d <br />. e <br />`,r~ <br />. <br />.% <br />PRODUCER <br />Aon Risk Services, In[ of Florida THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORDIATION ONLY <br />222 Lakeview Avenue AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />Suite 510 CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE <br />West Palm Beach FL 33401 US0. COVERAGE AFFORDED Bl' THE POLICIES BELOW, <br /> INSURERS AFFORDING COVERAGE <br />Pxone~ 866 283-7124 FAx- 866 430-1035 <br />INSURED INSURER A-. L2Xl^Jt00 Insurance Company <br />oxbow carbon & Minerals LLC INSURER B~ Federal Insurance Company <br />1601 FO rum P1 <br />Attn: Donna J. Gul bran Sen <br />west Palm Beach FL 33401-8101 USA JNSURERC <br /> <br /> INSURER D: <br /> INSURER E: <br />-GOVERAGES'ThiS-~IItfICffiC $§ROIIDtC11(IClI1O CCIN--81I-fA(IDIS@11ICDlS, COVCI3 C8`tCLi115~GOn0RIU8S 2nd C%CIDfr10i1S 0~[bC 11CICS SIMiwD.'~ -.:. SIR-. M8 .A <br />Y PP <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANbING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY <br />PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREI N IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. <br />AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />Tl'PE OF INSURANCE <br />POLIC1'NUMBER POL10'EFFECpI' <br />' POLICI'ESPIAATIOF <br />' <br />' <br />LIM1IITS <br /> DATE(MTRDD09 <br />) DATE(NI>NiD\l <br />1 <br />) <br />A GENERAL LUee.ITY $270634 12/01/03 12/01/04 EACH O[cuRRENCE 81,000,000 <br /> X COM1IAORCIAL GENERAL LIABRITY FIRE DAMAGE(Anr oeu fire: $50,000 <br /> CLAIMS MADE ~X OCCUR MED EXP (Anv one oersonl <br /> PERSONAL$AD1'EVJURY $1,000,000 <br /> GENERAL AGGREGATE E1,000, OOO <br /> <br /> GENL AGGREGATE LL11R APPLIES PER: <br /> PRODUCTS-COMP/OP AGG $1,000,000 <br /> PRO- <br />~ <br />O <br /> POLICY <br />LOC <br />JECT <br />B A UTOMOBILE LL>BILITI• 7307-F2-$8 09/01/04 09/01/05 GDMBINED SINGLE LIAJrF <br /> BUST De55 Automobile (Ea acaacm) $1,000,000 <br /> X ANYAUTO <br /> ALL OWNED AUTOS BODD.Y INIURY <br /> SCFB[DULED AUTOS (Per Persoa) <br /> HIRED AUTOS <br />BODB.Y INIURV <br /> RON OWNED AUTOS (Per aecidenp <br /> PROPERTY DAMAGE <br /> (Pa aaidevp <br /> <br /> GAIUGE L4161LITV AUTO ONLY - EA ACCIDENT <br /> ANY AUTO <br />OTHER THAN EA ACC <br /> AUTOONLY: <br /> AGG <br /> EXCESS LIABILITI' EACH OCCURRENCE <br /> OCCUR ^ CLALMS MADE AG'G'REGATE <br /> <br /> DEDUCTD3LE <br /> RETENTION <br /> WORKERS COXIPENSATION AND WC STATU- OTH- <br /> ' <br />' TDRY LIAl1TS ER <br /> EIIPLOI <br />LIABILITY <br />ERS E.L. EACH ACCIDENT <br /> E L DISEASE-POLICY LLnfIT <br /> EL. DISEASE-EA EMPLOYEE <br /> OTHER <br />RECEI~I~C~ <br />DESCRIPTION OF OPERATIOKSILOCATIONS/VEHICLES/EXCLUSIONS ADDED 91'-F,NpORSEAIENT/SPECIAL PRO\'ISIOFS <br />f <br />SEP 16 2U <br />0 Y <br />C£R'~EF'[~A-FEHOLOER ';~ -:, "fiV~inat% ,. '-:;' CAPtC£'-~AT't0 :°, _ - .~' - <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DI VI SI On Of Ml ^erd15 & G20IOyy DATE THEREOF, THE ISSUING CODIPANY N'ILL ERDEAVORTO MAIL <br />Attn: Blll Carter iO DAYS WRITFEN NOTICE TO THE CERTIFICATE HOLDERNAMED TO THE LEFT, <br />1313 Sherman Street, ROOM 215 BUT FAILURE TO DO SO SHALL L>mOSE NO OBLIGATION OR LIABILITI' <br />Denver CO $0203 USA OF AVY KINT)UPON THE COMPANY. ITS AGENTS OR REPRESENTATR'ES. <br /> - <br />AUTHORIZED REPRESENTATIVE ~/- / /~~ <br />r..l<<..:(~! . rq. v <br />`ACORD25-ff 7197 .-~P."~~~ s°=,• ~`,.'~°:. =s~; .. °`• -'~ '` ,; -A ~D""-f)R O ' Tl N.1988 <br />4 <br />e <br />L <br />9 <br />9 <br />e <br />O <br />rn <br />O <br />O <br />O <br />n <br />Z <br />d <br />n <br />C <br />d <br />V <br />~~I <br />.:~ <br />!~ <br />_y7 <br />y" <br />~, <br />~e <br />~~ <br />~_ <br />
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