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GENERAL38685
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GENERAL38685
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Entry Properties
Last modified
8/24/2016 7:58:22 PM
Creation date
11/23/2007 9:47:59 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981008
IBM Index Class Name
General Documents
Doc Date
1/9/2003
Doc Name
Certificate of Liability Insurance
To
DMG
Permit Index Doc Type
Insurance
Media Type
D
Archive
No
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Ug~r <br />AcoRV CERTIFICATE OF BILITY INSURANCE OP ID GATE (MMIDD/YYY1~ <br />WESTE-1 O1 06 03 <br />PRODUCER C ' <br />~~1 <br />Haya Companies ~ end <br />80 South 8th Street #1650 <br />` 1, <br />~ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />` <br />Minneapolis MN 55402 `Q,\` <br />ood~~o\o9V <br />Phone: 612-333-3323 Fax: 612-37`3-7270 8\s <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />INSURED o\ <br />LDt wsuRERA: Lexin ton Insurance Co. <br />O~Nfg INSURER 8: <br />UTe9 tern Fue13 A9SOCiatiOR,IIIC. <br />Robert NorrCJard INSURER C: <br />P. 0. SOX 33424 <br />D <br />CO 80233 INSURER D: <br />enver INSURER E: <br />COVERAGES <br />THE POLICIES OF WSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A80VE FOR THE POLICY PERI00 INDICATED. NOTWRHSTANDING <br />ANV REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT W ITH RESPECT TO WHICH THIS CERTIFICATE MAV BE ISSUED OR <br />MAV PERTAIN, THE INSURANCE AFFORDED BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAV HAVE BEEN REDUCED BV PAID CLAIMS. <br />LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MMIDD/YY LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $1,000, QQQ <br />A X COMMERCIAL GENERAL LIABILITY 1152536 Q1/Ql/Q3 Q1/Ql/QQ PREMISES Ea occweMel S <br /> ClA1MS MADE OCCUR _ _ _ MED EXP (Any One person) E <br /> PERSONAL 8 ADV INJURY E <br /> GENERAL AGGREGATE f 2 QQQ, QQQ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG E2,000 QQQ <br /> POLICY jE~ LOC E $en. 2,000,QQQ <br /> AU TOMOBILE LIABILITY <br />ANY AUTO COMBINED SINGLE LIMB <br />(Ea ecddenq E <br /> ALL OWNED AUTOS <br />SCHEDULED AUTOS BODILY INJURY <br />(Per person) <br />f <br /> HIRED AUTOS <br /> <br />NON-0WNED AUTOS <br />BODILY INJURY <br />(Per actltlenU <br />f <br /> PROPERTY DAMAGE <br /> <br />(Per acoaenU f <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT f <br /> ANY AUTO OTHER THAN EA ACC f <br /> AUTO ONLY: qGG $ <br /> E%CESSNMBRELLA LIABILITY FJ.CH OCCURRENCE f25,000,QOQ <br />A x occuR ^CLAIMSMADE 5576765 01/01/03 01/01/04 AGGREGATE s25 000,000 <br /> f <br /> DEDUCTIBLE $ <br /> x RETENTION ESQ QQQ E <br /> WORKERS COMPENSATION AND <br />' TORY LIMITS ER <br /> EMPLOYERS <br />LIABILITY _ _.___ __._-_. ~_ __-. -E <br />-EACH ACCID <br />L <br />N <br />-- - - <br /> <br />ANYPROPRIETOR/PARTNERIEXECUTNE . <br />. <br />E <br />T f <br /> OFFICER/MEMBER EXCLUDED? E.L. DISEASE- <br />EAEMPLOYEE <br />S <br /> If yes tlesaiba ontler <br />SPECIAL PROVISIONS below <br />E.L. DISEASE-POLICY LIMIT <br />E <br /> OTHER <br />DESC RIPTON OF OPERATIONS /LOCATIONS /VEHIC LES / EXCLUSIONS ADDED BY ENDORSE MENT /SPECIAL PRO VISIONS <br />Evidence of Insurance as respects <br />New Horizon Mine in Nucla, CO (Permit #C-81-008). <br />CERTIFICATE HOLDER <br />COLOR-2 SHOULD ANV OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE E%PIRATIOI <br />Colorado Mined Land DATE THEREOF, THE ISSUING INSURER WILL ENOEAVORTO MAIL 3Q DAYS WRRTEN <br />Reclamation NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />Mind Land Di V].3l.On IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />1313 Sherman Street, RM 215 <br />Denver ~,'~ 802Q3 REPRESENTATIVES. <br />
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