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GENERAL46405
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GENERAL46405
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Entry Properties
Last modified
8/24/2016 8:19:36 PM
Creation date
11/23/2007 2:36:55 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981008
IBM Index Class Name
General Documents
Doc Date
1/12/2006
Doc Name
Certificate of Liabilty Insurance
To
DMG
Permit Index Doc Type
Insurance
Media Type
D
Archive
No
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acoRV CERTIFICATE OF LIABILITY INSURANCE CSR MA- °ATE,MM/°D/YYYV) <br />WESTE-1 O1 09 06 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Hays Companies HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />80 South 8th Street #700 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Minneapolis MN 55402 <br />Phone: 612-333-3323 Fax: 612-373-7270 INSURERS AFFORDING COVERAGE NAIC# <br />INSURED INSURER A: WeitCheSter $ur lua Lines <br /> INSURER B: Illinois union Insu,:ance co. <br />Western Fuels Association,Inc. <br />Attn: Nancy Kelly INSURER C: <br />P. G. HOX 33424 <br />Denver CO 80233 INSURER D: <br /> <br /> INSURER E: <br />COVERAGES' ~ - ~-' ~ ~ - - - - - ~ - - <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANV REQUIREMENT, TERM OR CONDITION OF ANV CONTRACTOR OTHER DOCUMENT WITH 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 BY PAID CLAIMS. <br />LTR NSR TYPE OF INSURANCE POLICY NUMBER PATE MMIDDIW PATE MMID~(YV N LNMS <br /> GENERAL LUIBILITY EACH OCCURRENCE $1,000,000 <br />A X COMMERCIAL GENERAL LIABILITY G2203375A001 01/01/06 01/01/07 PREMISES (EaDCCUrence $50,000 <br /> CLAIMB MADE ~ OCCUR MED E%P (Any one person) $ 1Q, QQQ <br /> PERSONAL BADV INJURY $l, QQQ, QQQ <br /> GENERAL AGGREGATE $2, QQQ, QQQ <br /> GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ 2 ,QQQ , OOO <br /> POLICY PRO LOC <br />JECT Em Hen. 1 QQQ, QQQ <br /> AUT OMOBILE LIABILRY <br />COMBINED SINGLE LIMIT <br />$ <br /> ANY AUTO (Ea accident) <br /> ALL OW NED AUTOS <br />BODILY INJURY <br />$ <br /> SCHEDULED AUTOS (Per person) <br /> HIRED AUTOS <br />BODILY INJURY <br />$ <br /> NONAWNED AUTOS (Per acddenl) <br /> PROPERTY DAMAGE <br /> <br />(Per accident) $ <br /> GARAGE LIABILRV ~ - AUTOONLV-EA ACCIDENT' $ <br /> ANV AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: - AGG $ <br /> EXCESSIUMBRELLALUIBILRY EACH OCCURRENCE $20,000,000 <br />$ }[ OCCUR CLAIMS MADE X00 623572916 01/01/06 Q1~Ql~Q7 AGGREGATE $2Q, QQQ, QQQ <br /> $ <br /> DEDUCTIBLE $ <br /> }( RETENTION $SQ,000 $ <br /> WORKERS COMPENSATION AND TORY LIMITS ER <br /> EMPLOYERS' LNBILITY <br />ANV PROPRIETOR/PARTNER/EXECUTIVE <br />E.L. EACH ACCIDENT <br />$ <br /> OFFICER/MEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $ <br /> If yes, tlescdbe antler <br />SPECIAL PROVISIONS below _ <br />_ <br />E.L DISEASE-POLICY LIMIT <br />$ <br /> OTHER <br /> ~~ <br />DESCRIPTK)N OF OPERATIONS (LOCATIONS /VEHICLES / E%DLUSIONS ADDED BV ENDORSEMENT / SPECUAL PROVISIONS <br />Evidence of Insurance as respects <br />New Horizon Mine in Nucla, CO (Permit #C-81-008) .IAN 12 2006 <br />Includes use of Explosives <br />Division m Mi <br />nerals and Geology <br />cenllncAle nu~u~rc <br />Colorado Mined Land <br />Reclamation <br />Mined Land Division <br />1313 Sherman Street, <br />Denver CO 80203 <br />ACORD 25 <br />COLOR-2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O DAYB WRRTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 50 SHALL <br />RM 215 IMPOSE NO OBLIGATION OR LU\BILRV OF ANV KIND UPON THE INSURER, RS AGENTS OR <br />REPRESENTATNES. <br />1988 <br />
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