My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
GENERAL49078
DRMS
>
Back File Migration
>
General Documents
>
GENERAL49078
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
8/24/2016 8:27:07 PM
Creation date
11/23/2007 4:50:17 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981018
IBM Index Class Name
General Documents
Doc Date
3/15/2007
Doc Name
Certificate of Liability Insurance (E-mailed)
To
DRMS
Permit Index Doc Type
Insurance
Media Type
D
Archive
No
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
Page 1 of 1
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
ACORD CERTIFICATE OF LIABILITY INSURANCE CSR DN DATE (MMIDDIYYYY) <br />DESER-3 03 14 07 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Hays Companiea HOLDER. THIS CERTIFICATE DOES N07 AMEND, EXTEND OR <br />SO South Bth Street N700 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: Libozty Nukual Inavzaruo Co <br /> INSURER B.- <br />Deseret Generation 6 Transmlas <br /> <br />Attn: Soren Sorensen INSURER C: <br />10714 South Jordan Gateway <br />South J <br />dan UT 84095 INSURER D- <br />or <br /> INSURER E'. <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD I G <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICA <br />MAY 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 BV PAID CLAIMS. <br />LTR NSRD TYPE OF INSURANCE POLICY NUMBER DATE MMIDD/YY DATE MM/DDIYY LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1 , OOO , OOO <br />A X COMMERCIAL GENERAL LIABILITY T81-641-436749-026 12/30/06 12(3U(07 PREMISES (Eaoccurence) $ 100,GOG <br /> CLAIMS MADE X~ OCCUR MED EXP (Any one person) $ l0 , GOG <br /> R EBL SS,000,OOO PERSONALBADVINJURY $ 1,000,000 <br /> GENERAL AGGREGATE 8 2 , OOO , OOO <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS ~ COMP/OP AGG $ 2 , OOO , OOO <br /> POLICY PRO <br />JEGT LOC <br /> AUT OMOBILE LIABILITY <br /> COMBINED SINGLE LIMIT $ <br /> ANV AUTO (Ea accitlenp <br /> ALL OWNED AUTOS <br />BODILY INJURY <br /> <br />SCHEDULED AUTOS <br />(Per person) $ <br /> HIRED AUTOS <br />BODILY INJURY <br />$ <br /> NON-0W NED AUTOS (Per accitlent) <br /> PROPERTY DAMAGE <br /> <br />(Per accitleng $ <br /> GARAGE LIABILITY AUTOONLV~EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EA AGC S <br /> AUTO ONLY: AGG $ <br /> EXCESSNMBRELLA LIABILITY EACH OCCURRENCE $ <br /> OCCUR ~ CLAIMS MADE AGGREGATE $ <br /> $ <br /> DEDUCTIBLE S <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND TORY LIMBS ER <br /> EMPLOYERS' LIABILITY <br /> <br />ANV PROPRIETOR/PARTNER/EXECU-VE E.L. EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? E. L. DISEASE-EA EMPLOYE S <br /> II yes, tlescribe untler <br /> SPECIAL PROWSIONS below E.L. DISEASE-POLICY LIMIT S <br /> OTHER <br />DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />Re: Deserado Mine in Rangely, Colorado (Permit NC-81-O18). <br />CERTIFICATE HOLDER CANCELLATION <br />State of Colorado <br />Division o£ Reclamation, <br />Mining 6 Safety <br />1313 Sherman Street Room 215 <br />Denver CO 80203 <br />COLSTAS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE E%PIRATIC <br />DATE THEREOF, THE ISSUING INSURER WILL-MAIL 3O DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />
The URL can be used to link to this page
Your browser does not support the video tag.