Laserfiche WebLink
acoRV CERTIFICATE OF LIABI ~$ P DA <br />LITY INSURANC~ <br /> ~ o <br />DS/19/04 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Blanchard Insurance Group Inc . HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />P.O. Box 60130 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Grand Junction CO 61506 ~- <br />Phone:970-245-8011 Fax: 970-245-8016 INBURERS AFFORDING COVERAGE <br />INSURED INSURER A <br />FSTlployers Mutual Casualty Co. <br /> INSURER B: <br />$EDl COIIatrllCt lOII CO. INSURER C: <br />715 HOrizon Drive, $nlte 219 <br />Gra <br />ncti <br />n CO 81506 <br />d J INSURER D' <br />n <br />u <br />o <br /> INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED PBOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANV REQUIREMENT, TERM OR CONDITION OF ANV CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAV BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED DV 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 TYPE OF INSURANCE POLICY NUMBER GATE MMIOD/YY DATE MM/DD/VV LIMITS <br /> GENERAL LIABILRY EACH OCCURRENCE $1~000~000 <br />A X COMMERCIAL GENERAL LIABILITY 9X90868 05/10/04 05/10/05 FIRE DAMAGE (Any one lire) S 100,000 <br /> CLAIMS MADE ~ OCCUR MED EXP (Any one person) S 5 T OOO <br /> PERSONALS ADV INJURY $ 1, OOO ~ OOO <br /> GENERAL AGGREGATE $ 2 ~ OOO ~ OOO <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2~000TOOO <br /> POLICY JET LOC <br /> AUT OMOBILE LIABILDY <br />coMBINEDSINGLELIMIT <br />g1, 000 OOO <br />~ <br />A X ANY AUTO 9X90868 05/10/04 05/10/05 (Ea accitlent) <br /> ALL OW NED AUTOS <br />BODILY INJURY <br />$ <br /> SCHEDULED AUTOS (Per person) <br /> ]( HIRED AUTOS <br />BODILY INJURY <br />$ <br /> $ NON~OWNED AUTOS (Per accidant) <br /> RECEIVE PROPERTY DAMAGE <br /> (Per accident) $ <br /> GARAGE LIABILITY I~• 2 <br />' AUTO ONLY-EA ACCIDENT § <br /> ANY AUTO ~ <br />A OTHER THAN ~ ~C § <br /> IO AUTO ONLY: AGG $ <br /> EXCESS LIABILRV EACH OCCURRENCE $ <br /> OCCUR ~ CLAIMS MADE AGGREGATE § <br /> § <br /> DEDUCTIBLE $ <br /> RETENTION § $ <br /> WORKERS COMPENSATION AND 70RV LIMITS ER <br /> EMPLOYERS' LIgBILITY <br /> EbEAGH-ACCIDEN?- - ~S <br /> <br /> E.L. DISEASE ~ EA EMPLOYE § <br /> E.L. DISEASE ~ POLICY LIMIT $ <br /> OTHER <br />DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIE%CLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />RE: Slue Ribbon Mine-File No C-81-047. State Of Colorado, Division Of <br />Minerals & Geology is included as as Additional Insured.*10 Days Notice Due <br />to Noa-Payment Of Premium.**Or incur substantive changes or Failure to <br />renew.This certificate supercedes previously issued certificate <br />GCFIIIf11.A1C TtULUCM N ADDITIONAL INSUHED~INBURER LETTER: GNIVI.CLLX 11V1Y . <br />OOOOOOO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE E%PIRATION <br />State Of (,'OSOIadO GATE THEREOF, THE ISSUING INSURER WILL80®~.~MAII *30 DAYS WRITTEN <br />Di V1 B10n Df Miner8ls & GBOlOgy NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT 76tN[K <br />1313 Sherman Straet Room 215 -®TOSS]ca®LC6xammOAxomN[RpRN1T1K~RR18fONAL~Ulb74l~RSk?f4]P4KX~@P <br />Denver CO 80203 <br />ACORD 25.5 <br />6 ACORD CORPORATION 1988 <br />