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GENERAL38698
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GENERAL38698
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Entry Properties
Last modified
8/24/2016 7:58:22 PM
Creation date
11/23/2007 9:48:12 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1996083
IBM Index Class Name
General Documents
Doc Date
5/30/2006
Doc Name
Certificate of Liability Insurance
To
DMG
Permit Index Doc Type
Insurance
Media Type
D
Archive
No
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i ~ <br />~ ~~R~'W ~~~~~ ~~ ~~~~ DIYY) <br />~~~~~ ~~~URi~'R~~~ <br />D <br /> rw .~ <br />5/24/O6 <br />~ <br /> PRODUCER ~ ~~~ ~ ~~~~~ ~~~~ ~~~ ~~~ THIS CERTIFICATE IS ISSUED AS <br />A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> Aoordie of WV-Baakley HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 41 Eagles Read ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Beckley WV 25801 COMPANIES AFFORDING COVERAGE <br /> (304) 252-6375 <br />O COMPANY <br /> `I~ <br />V /~ Federal Insurance Company <br /> INSURED ~] COM <br />PANY <br />K <br /> p <br />Boris Resouroes, LLC ` <br />_ <br />QOO~ p <br /> n <br />O I~ <br /> 1500 Big Run Road M J <br />COMPANY <br />~~ <br />pl~y <br />~ <br /> Ashl end, KV 41102 `" <br />dGo <br />( <br />. <br /> n <br />a <br />M1~Ig5 COMPANY <br /> APOI <br />D <br /> COYEAAGE5 ..:' , <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELO W HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED,NOT W ITHS7ANDINGANV REOUIREMENT,TERMORCONDITION OF AN V CONTRACTOROTHERDOCUMENT W ITHRESPECT TO W HICHTHIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT 70 ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> CO TYPE OFINSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY E%PIRATION LIMITS <br /> LTR DATE (MMIDDIYYI DATE (MMIDDIYYI <br /> A GE NERAL LIABB.m 37111143 5/31/06 5!31/07 GENERAL AGGREGATE t 2,000,000 <br /> K COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ 1,000,000 <br /> CLAIMS MADE ~ OCCUR PERSONAL 6 ADV INJURY 4 1,000,000 <br /> OWNER'S 8 CONTRACTOR'S PROs EACH OCCURRENCE S 1,000,000 <br /> FIRE DAMAGE (Any ane tiro) S 1,000,000 <br /> MED EXP (Any one person) Y 10,000 <br /> AUT OMOBRE LIABdm <br />COMBINED SINGLE LIMIT <br />$ <br /> ANY AUTO <br /> ALL OWNED AUTOS BODILY INJURY t <br /> (Per person) <br /> SCHEDULED AUTOS <br /> HIRED AUTOS BODILY INJURY <br />4 <br /> NON-OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE g <br /> <br /> GARAGE LIABRm AUTO ONLY - EA ACCIDENT S <br /> ANY AUTO OTHER THAN AUTO ONLY: <br />, <br /> EACH ACCIDENT 4 <br /> AGGREGATE S <br /> E%CESS LIABB.RY EACH OCCURRENCE $ <br /> UMBRELLA FORM AGGREGATE S <br /> OTHER THAN UMBRELLA FORM S <br /> WORKERS COMPENSATION ANO - ~ ~ WRY AITU~ OTH- <br /> EMPLOYERS' LIABLITY <br />EL EACH ACCIDENT <br />$ <br /> THE PROPRIETOR/ <br />PARTNERS/E%ECUTIVE INCL EL DISEASE-POLICY LIMIT S <br /> OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE 4 <br /> OTHER <br /> DESCRIPTION OF OpERATION5ILOCATIONSIVEHICLESISPECIAL ITEMS <br /> Permit ilC-81-038 and Permit #C-96-083 <br /> CERTjFICATE HOLDER .. .. CAN£ELLATiON; ... ,_ <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 7NE <br /> State of COI Of adO E%PIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL <br /> Div(sion of Yi nerals $ Geology ~;~'10 DAYS WRRTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br /> 8UT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABRRY <br />1313 Sherman Street, Pon 215 ~ <br /> _ __ <br />Oenvar, CO 80203 ~~~ \-r-OF~~ANV KIND UPON THE COMPANY, RS AGENTS OR REPRESENTATIVES. <br /> AUTNORI2ED REPRESENTATIVE <br /> Janice C. Whltleek, AAI, CPIW <br /> ACQRt~25.S 1~9$ QACORDC#Jf1PORATICltJiyBa'; <br />CERT IY ICAI E: UlU/OUl/ UUUL! <br />
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