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GENERAL46738
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GENERAL46738
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Entry Properties
Last modified
8/24/2016 8:20:59 PM
Creation date
11/23/2007 2:52:43 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981053
IBM Index Class Name
General Documents
Doc Date
5/11/1990
Doc Name
Certificate of Insurance
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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~. <br />~'OLICY NUMBER: C K R123578 <br />III IIIIIIIIIIIII III ~--+ ~-- - ~~~ <br />999 <br />CL 291 <br />(11-85) <br />TFIIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />CG 2l A4 1 1 A5 <br />LIMITATION OF COVERAGE TO DESIGNATED PREMISES OR PROJECT <br />This endorsement modifies insurance provided under the Inllowing: <br />COMMERCIAL GENERAL LlARII IlY COVEItAGf I'NtT <br />SCHEDULE <br />Premises: ~ 4.1 ACRES LOCATED: <br />WEST 400° OF NE4 OF NEB <br />SECTION 31, TOWNSHIP 35, RANGE 11 WEST <br />N.M.P.M., LA PLATA COUNTY, COLORADO <br />Project: MINING OPERATIONS ARE NOT COVERED RY THIS POLICY <br />(I( no entry appears above, inlurmalion required to complete this endnrseinent will be shown in the Declarations as <br />applicable to llris endorsement.) <br />This insurance applies only to "bodily inprty", "property damage", "personal Injury", "advertising injury" and medical <br />expenses arising out of: <br />1. The ownership,maintenanu:wnseullhr.premisesshowniolhc:Sr.hedulr.andoperationsnec.essary or incidental to <br />those premises; or <br />2. The protect shown in the Sclrerlule. <br />* PREMISES IS LIMITED TO "DISTURBED AREA" LISTED ABOVE, DISTURBED <br />AREA MEANS AN AREA WfIGRE VEGETA'CION, TnP SOTL SPOIL, COAT. PROCESSING <br />WASTE UNDERGROUND nevl.r.oPMENT WAS'PE Olt NONCOAL WASTE IS PLACED BY <br />Sl1RFAC1: COAT, MINING OPERATIONS. 'I'IIOSI: AREAS ARI; CT.ASSIFII;U AS <br />DT.STURRED UNTIL RECT.AP1A'l'ION IS COMPI.E'I'EU AND '1'Hii PERFORMANCE BOND <br />OR O'fH1:R ASSURANCE OL'' YIRFORMANCI: IS R]iLIiASED. <br />NOTICE: ADVANCE NOTICE OF 45 DAYS TS TO RE GIVEN TO <br />COMPANY IF MINING OPERATIONS ARE 'PO BEGIN. <br />ACCEPTED RY <br />' I' I'1' 1.1, <br />DA7'li <br />CU <br />XCG21M Copynghl. Insurance Services Olhce, Inc., )9HA <br />
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