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GENERAL49994
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GENERAL49994
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Entry Properties
Last modified
8/24/2016 8:29:56 PM
Creation date
11/23/2007 5:35:09 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981018
IBM Index Class Name
General Documents
Doc Date
1/28/2002
Doc Name
CERTIFICATES OF INSURANCE
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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Fo~~A <br />y Certificate Number: 36396A7 <br />ASSOCIATED ELECTRIC & GAS INSURANCE SERVICES LIMITED <br />Hamilton, Bermuda <br />CERTIFICATE OF INSURANCE <br />(Excess Liability) <br />This Certificate is furnished to the Certificate Holder named below as a matter of information only. <br />Neither this Certificate nor the issuance hereof makes the Certificate Holder an additional Insured under <br />the policy of insurance identified below (the "Policy") or modifies the Policy in any manner. The Policy <br />terms are solely as stated in the Policy or in any endorsement thereto. Any amendment, change or <br />extension of the Policy can only be effected by a specific endorsement issued by the Company and <br />attached to the Policy. <br />The undersigned hereby certifies that the Policy has been issued by Associated Electric 8 Gas Insurance <br />Services Limited (the "Company") to the Named Insured identified below for the coverage described <br />and for the policy period specified. <br />Notwithstanding any requirements, terms or conditions of any contract or other document with respect <br />to which this Certificate may be issued or to which it may pertain, the insurance afforded by the Policy <br />is subject to all of the terms of the Policy. <br />NAME OF INSURED: BLUE MOUNTAIN ENERGY, INC. <br />PRINCIPAL ADDRESS: P.O. BOX 1067, RANGELY, CO 81698 <br />POLICY POLICY From: 12-30-96 <br />NUMBER: X0363A1A96 PERIOD: To: 12-30-97 <br />RETROACTIVE DATE: DECEMBER 30, 1989 <br />DESCRIPTION OF COVERAGE: Claims-First-Made Excess Liability Policy <br />DESERADO MINE IN RANGELY, COLARADO (PERMIT #C-81-018) <br />LIMIT OF $ 400, 000 per occurrence and in the aggregate, where applicable. <br />LIABILITY: <br />DESCRIPTION <br />OF OPERATIONS: <br />Should the Policy be cancelled, assigned or changed in a manne~bhat is materially adverse to the <br />Insureds) under the Policy, the undersigned will days advance written notice <br />thereof to the Certificate Holder, <br />DATE: 12-23-96 <br />ISSUED TO: STATE OF COLORADO <br />DIVISION OF MINERALS & GEOLOGY <br />ADDRESS: 1313 SI-~RMAN STREET, ROCM 15 <br />DENVER, CO 80203 <br />BY: <br />("Certificate Holder") <br />AEGIS INSURANCE SERVICES, INC. <br />lJ <br />At Jersey City, New Jersey <br />sootte~ <br />Copies: White-Certificate Holder; Canary-Aegis Insurence Services, Inc.; Pink-Insured; Goldenrod-Broker <br />
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