My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
2009-01-05_GENERAL DOCUMENTS - C1981018
DRMS
>
Day Forward
>
General Documents
>
Coal
>
C1981018
>
2009-01-05_GENERAL DOCUMENTS - C1981018
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
8/24/2016 3:39:26 PM
Creation date
1/6/2009 10:47:47 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981018
IBM Index Class Name
GENERAL DOCUMENTS
Doc Date
1/5/2009
Doc Name
Emailed Certificate of Insurance
From
Scott Wanstedt
To
DRMS
Permit Index Doc Type
Insurance
Email Name
JDM
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.
/
4
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
OP ID ZO <br />ACM CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) <br />DESER-3 01/05/09 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Hays Companies HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />80 South 8th Street #700 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: Liberty Mutual insurance Co 23043 <br />Deseret Generation 6r INSURER B: <br />Transmission <br />Attn: Robert Dalley INSURER C: <br />10714 South Jordan Gateway INSURER D: <br />South Jordan UT 845 <br /> INSURER E: <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />IN5 <br />LTR <br />NSR <br />TYPE OF INSURANCE <br />POLICY NUMBER POLICY EFFECTIVE <br />DATE MWDD POLICY EXPIRA ION <br />DATE MWDD <br />LIMBS <br /> GENERAL LIABILITY EACH OCCURRENCE s2,000,000 <br />A X COMMERCIAL GENERAL LIABILITY TBl-641-436749-028 12/30/08 12/30/09 PREMISES (Ea occurence) s2,000,000 <br /> CLAIMS MADE FX ] OCCUR MED EXP (Any one person) $ 10, OOO <br /> PERSONAL & ADV INJURY $ 2, OOO, OOO <br /> X EBL $1 <br />000 <br />000 GENERAL AGGREGATE $ 2, 000, OOO <br /> , <br />, <br />GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 <br /> POLICY JEnC F-] LOC <br /> AUT OMOBILE LIABILITY <br />ANY AUTO COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ <br /> ALL OWNED AUTOS <br />SCHEDULED AUTOS BODILY INJURY <br />(Per person) <br />$ <br /> HIRED AUTOS <br />NON-OWNED AUTOS BODILY INJURY <br />(Per accident) $ <br /> PROPERTY DAMAGE $ <br /> (Per accident) <br /> GA RAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ <br /> OCCUR F_ICLAIMS MADE AGGREGATE $ <br /> <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND TORY LIMITS ER <br /> EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br /> If yes, describe under <br />SPECIAL PROVISIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ <br /> OTHER <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />Re: Deserado Mine in Rangely, Colorado (Permit #C-81-018). <br /> COLSTAI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />State of Colorado DATE THEREOF, THE ISSUING INSURER WILL -MAIL 30 DAYS WRITTEN <br />Division of Reclamation, NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT <br />Mining & Safety <br />1313 Sherman Street Room 215 <br />Denver CO 80203 <br /> AUT RIZED REPRE <br />ACORD 25 (2001/08)
The URL can be used to link to this page
Your browser does not support the video tag.