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GENERAL35876
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GENERAL35876
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Entry Properties
Last modified
8/24/2016 7:56:40 PM
Creation date
11/23/2007 8:29:49 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1984063
IBM Index Class Name
General Documents
Doc Date
9/7/2001
Doc Name
CERTIFICATE OF LIABILITY INSURANCE
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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111 n~nunuu m <br />acoRV CERTIFICATE OF LIABILITY INSI III IIIIIIIII1111111 C' DA09/04/01 <br />PRODUCER RECEDED ONILY ANDICONFERS NO RIGHTS U ON THE CERTIFOICATE ION <br />EnRisk Services , Inc . HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />Fort Worth6TX 7 6113 -2 624 SEp 01 2001 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Phone: 817-877-1884 INSURERS AFFORDING COVERAGE <br />INSURED INSURERA St. Paul Surplus Lines LIES. <br />Division Bf Minerals an <br />INSURER B <br />Abraxas Petroleum Corporation <br />Ms. Carol O'Brien INSURERC <br />P.O. Box 701007 INSURER D. <br />San Antonio TX 78270-1007 <br />INSURER E. <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANV REOUiREMENT, TERM OR CONDITION OF ANV CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH <br />POLIUES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BV PAID CLAIMS <br />IN R <br />LTR rypE OF INSURANCE POLICY NUMBER GATE MMIDDIYI' E GATE MMIDDm N LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE E 1,000,000 <br />A X COMMERCIAL GENERAL LIABILITY MII05531807 09/01/01 09/01/02 FIRE DAMAGE (Any pne nrel E 100,000 <br /> CLAIMS MADE OCCUR MED EXP IAny one person) S $, OOO <br /> PERSONALB ADV INJURY E 1,000,000 <br /> GENERAL AGGREGATE S 2,000,000 <br /> GEN'L AGGREGATE LIMB APPLIES PER: PRODUCTS~COMP/OP AGG E 1,000,000 <br /> X POLICY PRO LOC <br />JECT <br /> AUT OMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />S <br /> ANV AUTO (Ea aCCitlenll <br /> ALL OWNED AUTOS BODRV INJURY E <br /> SCHEDULED AUTOS IPeI person) <br /> HIRED AUTOS <br />BODILY INJURY <br />E <br /> NON~OWNED AUTOS (Per acotlenD <br /> PROPERTY DAMAGE <br /> <br />(Per attitlenp $ <br /> GARAGE LIABILITY AUTO ONLY ~ EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EA ACC E <br /> AUTO ONLY: AGG E <br /> E%CESS LIABILITY EACH OCCURRENCE S <br /> <br /> OCCUR ^ CLAIMS MADE AGGREGATE $ <br /> E <br /> DEDUCTIBLE E <br /> RETENTION E S <br /> WORKERS COMPENSATION AND TORY LIMITS ER <br /> EMPLOYERS' LIABILITY <br />-- _ <br />L EAC <br />H ACCIDENT <br />E <br />E <br /> _ _ _ <br />. <br />__ <br /> E.L. DISEASE - EA EMPLOYEE 8 <br /> E.L. DISEASE ~ POLICY LIMIT E <br /> OTHER <br />DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEJ(CLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS <br />It is warranted that no coal mining operations are being conducted by the <br />assured. <br />GEKIIHII:AIG MVLUtK N ADDITIONAL INSURED; INSURER LETTER:_ L.ANGCLLA I14rv <br />DZVOFMI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~9- DAYS WRITTEN <br />DlVl810n Of Minerals and NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL <br />Geol Ogy IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER.ITS AGENTS OR <br />Attn; Mr. Byron Walker <br />1313 Sherman Street REPRESENTATIVES. <br />Denver CO 80203 AUTHORIZED REPRESENTAi1Vw AA <br /> <br />A!`l1Tin 95.5 I]/Q]1 <br />
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