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GENERAL36465
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GENERAL36465
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Entry Properties
Last modified
8/24/2016 7:57:00 PM
Creation date
11/23/2007 8:45:19 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981035
IBM Index Class Name
General Documents
Doc Date
5/12/2006
Doc Name
Certificate of Liability Insurance
To
DMG
Permit Index Doc Type
Insurance
Media Type
D
Archive
No
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DATE <br />) <br />OSiosizoo6 <br />ACORD,. CERTIFICATE OF LIABILITY INSiTRANCE <br />PaobucER <br />AOn Risk serVi CeS of TeXaS,InC THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY <br />1330 post Oak el vd . AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />suite 900 CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE <br />Houston TX 77056-3089 USA COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> INSURERS AFFORDING COVERAGE NA[Cp <br />PxoNE_ 866 283-7124 FAX- 866 430-1035 <br />msuaeD msuRER A- Westchester Fire Insurance Co 21121 <br />National King Coal, LLC ~~ /`~D <br />~~ msURER B: Nati Dnal Union Fire Ins CD of .Pittsburgh 19445 <br />4424 County Road 120 -" ` <br />--~ <br />, <br />Hesperus Co"181 <br />USA ~ <br />''' <br />f <br />l~ <br />~ ~ msuPFR C: <br />cc <br />~ <br />~ ~,Qw <br />- ~ mSURER D: <br />1 <br />[[}} <br />i ..I <br />~ <br />6 <br />~ <br />U INSURER @ <br />COVERAGES 'e" ~ ""SIR .Md `A <br />THE POLICIā¬s OF INSURANCE LISTEQ~ELOW HAVEBEENISSU <br />a~7~ EMSURED NAMED ABOVEFOR THE POLICY PERIOD MDICATED. NOTWITHSTANDING <br />~ <br />ANY REQUIREMEM, TERM OR.~ION OF ANY C0~1'2:R91 OT ER DOCUMENT WITH RESPECT TO WHICH THIS CERTmICATE MAYBE ISSUED OR MAY <br />PERTAM, THE INSURANCE APPORDED BYORIE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. <br />AGGREGATE LIMITS SHOiV]V MAY HA VE BEEN REDUCED BY PAID CLAIMS. <br />iNSR <br />LTR ADD' <br />INS ,y,,,.~" <br />N TYPE OF mSURANCE <br />POLICY NUMBER pOLICV EFFECTIVE POLICY EXPIRA710N <br />LIMITS <br /> DATE(MMIDDIYY) DATE(MMIDDIYY) <br />e E~Y <br />G <br />ERAL LUBILITY GL071413$ 04/13/06 09/01/06 EACH OCCURRENCE 41,000,000 <br /> ~ <br />7 <br />COMMERCIAL GENERAL LIABILITY DAMAGE TO REMED $$0,000 <br /> _ PREMISES (Ea cccurmce) <br /> CLAIMS MADH ® OCCUR MED Any une person <br /> PERSONAL&ADV mNRY E1, 000, 000 <br /> ^ <br /> GENERAL AGGREGATE 000 <br />42 <br />000 <br /> ' , <br />, <br /> GEN <br />L AGGREGATE LIMIT APPLES PER: <br />PRODUCTS-COMP/OP AGG <br />E2,000, OOO <br /> ^X POLICY ^ PRO, ^ <br />LOC <br /> IECT <br />B AUT OMOB3LE LIABILTIY CA RO-$D-$$ 04/13/06 09/01/06 <br />COMBINED SINGLE LIMIT <br /> X ANY AUTO (Ea accidmQ El, DOD, 000 <br /> ALL OWNED ADIOS - BODILY INNRY <br /> SCHEDULED AUTOS (Pcr pcrson) <br /> X HIRED AUTOS f ~~~ <br /> BODILY INJURY <br /> NON OWNED AUTOS. ,' - ~ (Pm accidm0. - <br /> 51000 Comp Ded ~ PROPERTY DAMAGE <br /> <br /> 53000 Coll ced (Pa accidml) <br /> GARAGE CL1BfLTCY AUTO ONLY- EA ACCIbENT <br /> B ANY AUTO <br />OTHER THAN EA ACC <br /> AUTO ONLY <br /> AGG <br />A E%CE$$NMBRELLA LIABILITY 621985661001 09/01/05 09 O1 06 EACN OCCURRENCE <br /> ~OCCIRt ^ CLAIMS MADE AGGREGATE ES0, 000, 000 <br /> <br /> OEW )THEE- <br />` <br />-_ <br /> 410 <br />0 <br /> , <br />00 <br />RETENTION <br />B ' WC 4 X WC ETATU- OTH- <br /> 1S <br />ORKER4 COMPENSATION AND RY IMIT ER <br /> EMPLOYER$' LIABILITY BL. EACH ACGbENT $1,000,000 <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />E.L. DISEASE-EA EMPLOYEE <br />$1,000,000 <br /> Ifyes, dcsaibe wrier SPECIAL PROVISIONS E.L. DISEASE-POLICY LIMIT $1, DO0,000 <br /> below <br /> OTNER <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EICCLpSIONS ADDED BYENDORSEMENT/SPECIAL PRO VISIONS <br />see Attached: <br /> vy,a,D ~11lIDBf819811d ~~ <br />CERTI KATE AOLDER ' " CANCELLATION."~ '" <br />DI VI $1 On Of Minerals dOd GeOl Ogy ~ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />1313 Sherman street, ROOM 21S DATE THEREOF, THE ISSUING mSURER WILL EMBbAYBa-FO MAIL <br />DeOVer CO 80203 USA 30 DAYS WRITTEN NOTICE TO THE CERTDICATE HOLDER NAE7ED i0 TF~LEYL <br /> BUT FAILURE TO DO SO SHALL AROSE NO OBLIGATION OR LIABLLITY <br /> OF ANY KIND UPON THE INSURER, IT$ AGENTS OR REPRESEMATIVES. <br /> AUTHORIZED REPRESENTATIVE <br /> .r56w .mod' ~ ~"ezodeeb e~ `7exad. 7re~. <br />GO " 2 '200 08 : ~ .A"OR C~-... ~O ,~, ~." `."~ $8 <br />v <br />w <br />c <br />d <br />9 <br />9 <br />,Z <br />N <br />H <br />N <br />W <br />'nI <br />O <br />n <br />~i <br />
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