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GENERAL51138
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GENERAL51138
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Entry Properties
Last modified
8/24/2016 8:37:33 PM
Creation date
11/23/2007 6:33:59 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1983059
IBM Index Class Name
General Documents
Doc Date
6/25/2007
Doc Name
Certificate of Liability Insurance
To
DRMS
Permit Index Doc Type
Insurance
Media Type
D
Archive
No
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Attachment to ACORD Certificate for oxbow carbDn & Minerals LLc <br />The terms, conditions and provisions noted below are hereby attached to [he captioned certiScate as additional description of the coverage <br />afforded by the insurer(s). This attachment does not contain all terms, wnditions, coverages or exclusions contained in the policy. <br />INSURED <br />Oxbow Carbon & Minerals LLC <br />1601 Forum P1 <br />Attn: Donna ]. Gulbransen <br />West Palm aeach FL 33401-8101 USA <br />INSURER <br />INSURER <br />ADDTTIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD <br />certiScate form for policy limits. <br /> <br />DVSR <br />LTft ADD'L <br />INSRD <br />TYPE OF DVSURANCE POLICY NUMBER <br /> <br />POLICY DESCRIPTION POLICY <br />EFFECTn'E <br />DATE POLICY <br />EXPDiATION <br />DATE <br /> <br />LRITrS <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />DESCRIPTION <br />BV ENDORSEA¢NT/SPECLll. PROVISIONS <br />RE: terror Creek Comoany_C_1983=059 _..-- - - <br />commercial General Liability covers use of explosives. <br />Division of Minerals & Geology is named as an Additional insured excluding workers' compensation and <br />Employers' Liability as required by written contract but limited to the operations of the insured under <br />said contract, and always subject to the policy terms, conditions and exclusions. <br />Certificate No : 570023233416 <br />
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