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GENERAL46764
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GENERAL46764
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Last modified
8/24/2016 8:21:04 PM
Creation date
11/23/2007 2:53:29 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981022
IBM Index Class Name
General Documents
Doc Date
12/27/2005
Doc Name
Certificate of Insurances
Permit Index Doc Type
Insurance
Media Type
D
Archive
No
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~ ^ASS,~~~ ,a ~-~~,, ~ <br />ACORD <br />~ ~ <br />~KK <br />O <br />~ <br />° <br />~ ~%'a~ s '~'~. ~~T ~r~`' ° DATE CMM/DD vv) <br />~ F <br />~ <br />~+~ <br />r« <br />~a <br />~ <br />~ <br />_ <br />~ T iz/zz/os <br />S <br />elxoouceR <br />AOn R1 sk SerVl CeS, Inc Of Fl Orl dd THIS CERTIFICATE IS ISSUED .4S A DIATTER OF 1NFORDI.4TION ONLY <br />222 Lakeview Avenue AND CONFERS NO RIGHTS I1PON THE CERTIFICATE HOLDER. THIS <br />Suite 510 CERTIFICATE DOES NOT AM1IEND, ESTERD OR ALTER THE <br />weft Palm Beach FL 33401 USA CO\'ER4GE AFFORDED B\"FHE POLICIES BELO\\'. <br /> ENSURERS AFFORDING CO\'ER4GE <br />exosE~(866 283-7124 FAx- 866) 430-1035 <br />INSURED wsuRERA: Hartford Fire lnsurance Co. <br />Oxbow carbon & Minerals LLC INSURER 6: Lexington insurance company <br />1601 Forum P1 <br />Attn: Donna i <br />Gul bransen <br />. <br />west Palm Beach FL 33401-8101 USA msuRERc <br /> ENSURER D. ED <br /> INSURER E <br />>NCO)~F,R~IGF.S;Ttiis:Geitificaieisnz+TlDielided.tis=s ecifiTtill'eridorsenient3:~ttrier a_es:lemts?°zandiuDn's,and eaclluioitsdE.the~--is"s~-D -' ~"SiR~;M1}ay~_App%; y. <br />THE POLICIES OF INSURANCE LISTED BELOU' HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PE E WITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OT HER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY <br />PERTAIN, THE INSURANCE AFFORDED Bl' THE POLICIES DESCRIBED H EREIN IS SUBIECT TO ALL THE TERMS, EXCLUSIONS AND CONDIT70NS 4gF <br />SUCH POLICIES. <br />~~~ <br />AGGREGATE LIMITS SHOWN MA}' HAVE BEEN REDUCED Bt' PAID CLAIMS. f inerals d GBOWyy <br />IpSR <br />LTR <br />T}PC OF 65t'R{NCE <br />POLICP SD)IBER POLICI'EFFECTI\' <br />' POLICY ESPIR{TIOS <br />' <br />" <br />LI91T$ <br /> D,ATEpIDHDDI}l <br />) OATEI]Ifi\DD\1 <br />1 <br />1 <br />R GESERaL LIADILITY 7287D35 12/Ol/Q$ 06/01/06 EACH OCCLRRE.\CE $1, DDO, 000 <br /> X CO\LatERCL{L GEN'ER.AL LIAHILIT}' FIRE D.{.afAGElAnc one lre $50,000 <br /> CLAI)15,{IaDE X^OCCLR afED E\P fdnc wettwnl <br /> PERSOSALB.{D\'IVURI' $1,000,000 <br /> GE~ERaL.{cGREGATE 51,000,000 <br /> <br /> GE\"L .{GGREGATE LI\IIT .iPPLIES PER <br /> PRODCCTS-[O{D`OP AGG $1,000,000 <br /> PRO- <br />~ <br />~ <br /> POLICY <br />LOC <br />IECT <br />A A fTOaIODILE LIADILITY 2DUENZQ6228 09/01/0$ 09/01/06 CO\181NED SIYGLE LI]RT <br /> BU510255 automobile fEa acddrn0 51,000 <br />000 <br /> X .{\l'ALTO , <br /> .{LL OR^.\T'D ALTOS BODRI' INILRI" <br /> SCt1EDULED ALTOS (Per person) <br /> HDtEU dCTUS BODRI" IV LRY <br /> (Per acciden0 <br /> ]ON Ott:CED ALTOS <br /> PROPERT}"D.4\IAGE <br /> (PeraccidenU <br /> <br /> GAR{GC LIAHILITI ALTO OSLY - EA ACCIDENT <br /> A~l'ALTO OTHER YHA!: EA AC[ <br /> ACTOOSLI': <br /> {GG <br /> ESCESS LLaHILITT EACH OKL'RRE]CE <br /> UCCL'R ^ CLAI{15 MADE AGGREGATE <br /> <br /> UEUI CHDLE <br /> RETENTION <br /> <br />\{ORRERS CO)IPENSATIOS ASU <br />' <br />' \eC STATE- OTH- <br />TOR\'LIAI TS ER <br /> E{IPLOTERS <br />LIADILIT} E L EACH ACCIDEST <br /> EL DISEASE-POLIC}'LNR <br /> L. DISEASE-EA EAtPL01'EE <br /> OTHER <br />DESCRIPTION OF OPERAT103S,LOCATI0S5~VEHICLES E]CLCSIO]5 ADDEU BT ESDORSE~IENT~SPKI,{L PROVISIOSS <br /> <br />„~e~ <br />CER`ITF;ICATE'FIOLDER •~' ;_- °~ .'.•:,.._ .Y= . •.CANGELGA`f10N'~..'`~':€' '' *°~,ne.z„„~' e+.*a.~€=~«~`.'.~`..zi.~:.~~::~'.~'~'.~-€z' <br />DI VI $1 On Of Minerals & Geology SHOULD ASI'OF THE.{BO\'[DESCRIBED POLICIES BE CASCELLEDHEFORE THE E\PIRATIOS <br />' <br />' <br />Attn: Bill Carter DATE THEREOF, THE ISSUIFG COMPAN} <br />\\ <br />IL1. E]DEACOR TO MAIL <br />1313 Sherman street, ROOM 21S iO Dd}'S\VRITTEN NOTICE TO THE CERTIFICATE HOLDER NA\IED TO THE LEFT, <br />' <br />Denver CO 80203 USA BLT FAILURE TO DO SO SHALL ^IPOSE NO OBLIGATION OR LIABILIT{ <br />' <br />' <br />' <br /> Y xIND UPON THE CO VPA\1 <br />. IT5.4GEMS OA REPRESEATATII <br />OF A~ <br />ES. <br /> AUTHORIZED REPRESENTATI\E ~/~ ~ /~ / <br /> <br />. ~ <br />-'A~ORU 25 S`, aW=7. "a ~...>b?=n.~'' w~:":.~:.,5?'.. B, ,.a_-- .'.~ T -~ ~: -~r v - z - --- ,. ~... .,_ <br />e.~~ ~.:~a_ ..~. ~sti~ .'~~~~s .~A'~ORDIGO"I~~O RA,TI(S1~tA>;8 <br />.~ <br />d <br />d <br />0 <br />n <br />n <br />N <br />O <br />O <br />n <br />Z <br />V <br />L <br />V <br /> <br />
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