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GENERAL38805
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Entry Properties
Last modified
8/24/2016 7:58:26 PM
Creation date
11/23/2007 9:50:47 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981014
IBM Index Class Name
General Documents
Doc Date
10/20/2004
Doc Name
Certificate of Liability Insurance
Permit Index Doc Type
Insurance
Media Type
D
Archive
No
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ACORD CERTIFICATE OF LI - ILITY INSURANCE CSR TS DATE (MMfDDmrY1 <br />ENERG-1 10 12/04 <br />PRODUCER _+~ <br />Hrown S Brown Insurance `U <br />Steamboat Spgs POB 775043 ~~`_ <br />2150 Resort Drive, #250 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 />Steamboat Springs CO 80477-504 <br />-Phone:-97-0-879=1363 Eax: 970r879-0239 -. <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />INSURED INSURER A: CHUBB & SON INC <br />' INSURER B: '~ ' - " ' - - - ' <br />Energy-FUel3 COrpOratlOn INSURER C: <br />PO BOX 773457 ~ <br />80477 <br />57 INSURER D: -- -- ' <br />Steamboat Springs CO <br />-34 INSURER E: '- <br />COVERAGES <br />' THE POLICIES OF INSURANCE LISTED BELOW HAVE OEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITMSTANOING <br />ANV REQUIREMENT, TERM OR CONDITION OF ANV CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAV PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BV PAID CLAIMS. <br />LiR NSR TYPE OFINSURANCE POLICY NUMBER DATE MMfOD/Y1' DATE MM/DOfYY LIMITS <br /> GENERAL LIABILITY EACN OCCURRENCE $2,000,000 <br />A X COMMERCIALGENERALLIABILITV CML012699001 10/01/04 12/01/04 PREMISES Eaoccurence $50,000 <br /> CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ 1D, GDD <br /> PERSONAL aAOV INJURY $2,000,000 <br /> GENERAL AGGREGATE $2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS- COMPIOP AGG $ 2 , GDG , D DG <br /> POLICY PE~ LOC Em Ben. 2 000,000 <br /> AUT OMOBILE LIABILITY ' <br />COMBINED SINGLE LIMIT <br />$ <br /> ANY AUTD (E33CCItlent) <br /> ALL OWNED AUTOS - ~ - - -- ~ -'- "- - <br />BODILYINJURY <br /> <br /> <br />~CHEPULERAUTOS_.:- .,: .. <br />„~ .. <br />- - <br />__ ._ ._ <br />..,.__.___ . <br /> <br />- _ .. <br />(Per person) <br />_. _ _ _ _ - $ <br /> - BODILY INJURY $ <br /> NON-OWNED AUTOS (Per acGtlent) <br /> PROPERTY DAMAGE <br /> <br />(Per accitlent) $ <br /> GA RAGE LIABILITY ~ AUTO ONLY-EA ACCIDENT $ <br /> ANV AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG 8 <br /> EXCESSNMBRELLA LIABILITY EACH OCCURRENCE $ <br /> <br /> OCCUR ^ CLAIMS MADE AGGREGATE $ <br /> <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND <br />' <br />I TORY LIMITS ER <br />- <br /> EMPLOYERS <br />LIABIL <br />TY - <br /> ANV PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? <br />E. L. DISEASE-EA EMPLOYEE <br />$ <br /> If yes, tlescnbe antler <br /> SPECIAL PROVISIONS LeIOw E. L. DISEASE-POLICY LIMIT $ <br /> OTHER <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIO <br />RE: Raton Creek Mine - Permit #C-62-055 <br />Kerr Mine -- Permit #C-SO-066 <br />T <br />0 2004 <br />Southfield Mine - Permit #C-81-014 ~C <br />~ <br />Newlin Creek Mine - Permit #C-61-045 <br />Division ~f Minerals and Geology <br />CERTIFICATE HOLDER CANCELLATION <br />CNATURA SHOULD ANY OF THE ABOVE OESCRIBEp POLICIES BE CANCELLED BEFORE THE E%PIRATION <br />Colorado Department Of DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O DAYS WRITTEN <br />Natural Resources NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, - <br />Division of Minerals fi Geology I <br />1313 Sherman Street, Rm 215 ' <br />Denver CO 80203 R <br /> AUTHORIZED RE SE IVE <br /> Scott or <br />LD I[uuT/ual - lam/ ~ ©ACORD CORPORATION 1988 <br />
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