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2008-07-07_GENERAL DOCUMENTS - C1981013
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2008-07-07_GENERAL DOCUMENTS - C1981013
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Last modified
8/24/2016 3:34:08 PM
Creation date
7/10/2008 10:00:47 AM
Metadata
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Template:
DRMS Permit Index
Permit No
C1981013
IBM Index Class Name
GENERAL DOCUMENTS
Doc Date
7/7/2008
Doc Name
Certificate of Liability
To
DRMS
Permit Index Doc Type
Insurance
Email Name
KAG
Media Type
D
Archive
No
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ACORD CERTIFICATE OF LIABILITY INSURANCE <br />PRODUCER <br />HILB ROGAL AND HOBBS OF TENNESSEE, INC. <br />120 MARKET PLACE BLVD. <br />KNOXVILLE, TN 37922 <br />665-251-5270 <br />INSURED , <br />BASIN RESOURCES, INC. <br />2 NORTH CASCADE AVE., 3RD FLOOR <br />COLORADO SPRINGS, CO 80903 <br />DATE 6/26/2008 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS <br />NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, <br />EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />INSURERS AFFORDING COVERAGE <br />INSURER A: NATIONAL UNION FIRE INS. CO. OF PITTSBURGH PA <br />INSURER B: <br />INSURER C: <br />INSURER D: <br />INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM <br />OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES <br />AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />OLICIES <br />. <br />DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH P <br /> POLICY EFFECTIVE POLICY EXPIRATION <br />INSR. <br />LTR TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YY) DATE (MMIDD/YY) LIMITS <br /> $1 <br />000 <br />000 <br /> NERAL LIABILITY EACH OCCURRENCE , <br />, <br />A GE <br />X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (ANY ONE FIRE) $50,000 <br /> CLAIMS MADE OCCUR GL643-18-68 7/1/2008 7/1/2009 MED EXP (ANY ONE PERSON) $5,000 <br /> 000 <br />$1 <br />000 <br /> X dil <br />I <br />l <br />d <br />B PERSONAL & ADV. INJURY , <br />, <br /> X o <br />y <br />njury <br />Inc <br />u <br />es <br />Dama <br />e <br />l <br />d <br />P <br />t GENERAL AGGREGATE $2,000,000 <br /> ' g <br />u <br />es <br />Inc <br />roper <br />y <br />AGGREGATE LIMITS APPLIES PER: PRODUCTS - COMP/OP AGO $2,000,000 <br /> GEN <br />L <br /> X POLICY PROJECT LOC <br /> COMBINED SINGLE LIMIT <br /> AUTOMOBILE LIABILITY <br /> TO (Each Accident) <br /> ANY AU <br /> ALL OWNED AUTOS BODILY INJURY <br /> ULED AUTOS (Per Person) <br /> SCHED <br /> BODILY INJURY <br /> HIRED AUTOS <br /> NED AUTOS (Per Accident) <br /> NON-OW <br /> PROPERTY DAMAGE , <br /> (Per Accident) <br /> AUTO ONLY- EACH ACCIDENT . <br /> GAR AGE LIABILITY <br /> AUTO OTHER THAN EA. ACC. <br /> ANY <br /> AUTO ONLY: AGG. <br /> I <br />ITY EACH OCCURRENCE <br /> EXCESS LIAB <br />L <br />UR F] CLAIMS MADE AGGREGATE <br /> OCC <br /> TIBLE <br /> DEDUC <br /> RETENTION $ <br /> - 4YC.STATUTORY-LIMITS <br />- ORKFR&COMPENSATION-ANO <br />W <br /> I <br />TY <br />' OTHER <br /> LIAB <br />LI <br />EMPLOYERS <br /> E.L. EACH ACCIDENT <br /> E.L. DISEASE - EA EMPLOYEE <br /> E.L. DISEASE - POLICY LIMIT <br /> OTHER RECEIVED <br />77 <br />DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS I <br />RE: THE GOLDEN EAGLE MINE PERMIT #C-81-013 Division or. Reclamation, <br />Mining and Safety <br />CERTIFICATE HOLDER AUUII IVNAL I-U- u <br />STATE OF COLORADO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE <br />MINED LAND RECLAMATION OFFICE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30• DAYS WRITTEN NOTICE TO THE <br />ATTN: JOSEPH DUDASH CERTIFICATE HOLDER NAMED TO THE LEFT. <br />ROOM 215 <br />1313 SHERMAN STREET <br />, <br />DENVER, CO 80203 AUTHORIZED PRESEN A <br />J <br />ACORD 25-S (6/01) "10 DAYS FOR NONPAYMENT OF PREMIUM
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