Laserfiche WebLink
CERTIFICATE NUMBER :. <br /> ~/h~1au <br />~~~~.. ~ Le~ p ~i.hA CC ~ryr EF~L~ p (~~+~1.C <br />lf7~~~~I'LTG Off' II `f~~A-f~~~IG -NYC-Om 14151 B-04 <br /> PRODUCER THIS CERTFCATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS <br /> MafSh USA IDC. NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE <br /> 1166 Avenue Df Americas POLICY. THIS CERTIFlCATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE <br /> NY 10036 <br />New Yolk AFFORDED BY THE POLICIES DESCRIBED HEREIN. <br /> , <br /> Attn: KEN HELM NEWYORK.CERTS®MARSH.COf•,f~ECEIVED <br />t"i <br />COMPANIES AFFORDING COVERAGE <br /> COMPANY <br /> 006046---OS-O6 A NSA <br /> INSURED COMPANY <br /> W. R. GRACE & CO. g WA <br /> 7500 GRACE DRIVE <br /> COLUMBIA, MD 21044 Division of Minerals & Geology COMPANY <br /> C HARTFORDINSURANCE OF THE MIDWEST <br /> COMPANY <br /> D HARTFORD FIRE INSURANCE COMPANY <br /> G`tIUEH¢LGES ,__ . ,c~inea<esBpersBnrEre~'aacesary~pravfpusTy fssBBB C+~t~ta lDrtlTe!c~ireNaB Hared beinw, .. _.,•. ,. -~ 4 . ., ,.,.:, , <br /> THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. <br /> NOTWITHSTANDING ANV REOUIREMEM, TERM OR CONDITION OF ANV CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAV BE ISSUED OR <br /> MAV PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND IXCLU310NS OF SUCH POLICIES. <br /> AGGREGATE LIMITS SHOWN MAV HAVE BEEN REDUCED BV PAID CLAIMS. <br /> CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE PODGY EXPIMTION LIMITS <br /> LTR DATE (MM/OD/YY) DATE (MM/DD/YY) <br /> - G ENERAL LIABWTY SELF INSURED 06/30/05 06/30/06 GENEPAL AGGREGRATE $ 5,000,000 <br /> X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ 5,000,000 <br /> <br />~ CLAIMS MADE OCCUR PERSONAL BAW IW URY $ 5,000,000 <br /> ~ OWNERS & COMRACTOR'3 PROT EACH OCCURRENCE $ 6,000,000 <br /> X SELF-INSURED FIRE DAMAGE(Any ane fire) $ 5,000,000 <br /> W.R. GRACE R CO MED IXP (Any one person) $ EXCLUDED <br /> D A UTOMOBILE LIABILITY 10 CSE C47908 (ADS) O6/30Po5 06!30/06 <br /> COMBINED SINGLE LIMIT $ 2,000,000 <br /> C X ANV AUTO 70 CSE C47909 (TX) O6f30Po5 06/30/06 <br /> C ALL OWNED AUTOS 10 CSE C47908 (IN, OK) 06/30/05 06!30/06 BODILY INJURY <br /> <br />D <br />SCHEDULED AUTOS <br />21 CSE C47910 (PR) <br />06/30/05 <br />O6f30/06 <br />(Per person) $ <br /> HIRED AUTOS BODILY INJURY <br />$ <br /> NON-OWNED AUT03 (par acdtlenq <br /> PROPERTY DAMAGE $ <br /> <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ <br /> ANY AUTO OTHER THAN AUTO ONLY: -_ "' <br /> EACH ACCIDENT $ <br /> AGGREGATE $ <br /> EXCESS LIABILITY EACH OCCURRENCE $ <br /> UMBRELLA FORM AGGREGATE $ <br /> OTHER THAN UMBRELLA FORM $ <br /> D WORKERS COMPENSATION ANO CT <br />FL <br />GA <br />IA) <br />10WNC47906 (CO O6I30/05 O6I30/O6 J( WC STATU- OTH- <br /> ' , <br />, <br />, <br />, TORY LIMITS ER '~ <br /> EMPLOYERS <br />UABIUTV (MO,NE,NV,NY,OH,OR,SD,WA,WV) EL EACH ACCIDEM $ 2,000,000 <br /> C THE PROPRIETOR/ X INCL 10WNG47906 (AR,AZ,DE,IL,KS,LA) 06/30/05 O6/30Po6 EL DISEASE-POLICY LIMIT $ 2,000,000 <br /> PARTNERS/EXECUTIVE <br />OFFICERS ARE: <br />IXCL <br />(MA,MD,ME,MI,NH,NJ,NM,OK,PA) <br />EL DISEASE-EACH EMPLOYEE <br />$ 2000000 <br /> OTHER <br /> DESCRIPTION OF OPERATIONSrLOCATIONSIVEHICLES/SPECIAL ITEMS <br /> The coverage antl Ilmils statetl aDOVe apply to PermK #Ce0-003 <br /> GEfiTGAT~ }KiLDER ._,. ,..~. __.~_, :~ ~,< < , ,. , ~~_. ~ . CANt~LU4TlQM-u ~ ,...~,~,. _~_u ~ ~,~ .~ ~ _~~ .. ~~ , ~ ~ - <br /> SHOULDANV OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE IXPIFiATION <br /> Colorado Division of Minerels and DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL 30 DAYS <br /> Geology WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH <br /> Attn: Jim Stark NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER <br /> 1313 Sherman Street -Room 215 AFFORDING COVERAGE, 1T9 AGEMS OR REPRESEMATIVES, OR THE ISSUER OF THIS <br /> Denver, CO 80203 CERTIFICATE. <br /> MARSH USA INC <br />Bv: Thomas J. Edntlge %7'Ip~YH0.d ¢-• '~ <br /> N~dl{5f6$i :VALID AS OF ~DN2S/05 `s <br />