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2009-10-13_HYDROLOGY - C1981010
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2009-10-13_HYDROLOGY - C1981010
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Last modified
8/24/2016 3:56:07 PM
Creation date
10/13/2009 1:30:32 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981010
IBM Index Class Name
HYDROLOGY
Doc Date
10/13/2009
Doc Name
Certificate of Liability Insurance
Permit Index Doc Type
Insurance
Email Name
JDM
Media Type
D
Archive
No
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DATE <br />M/DD/YYYY) <br />AC OW CERTIFICATE OF LIABILITY INSURANCE <br /> 0/01/ <br />11 <br />0/01/2009 <br />PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION <br />MARSH USA INC. <br />1225 17TH STREET <br />SUITE 2100 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />, <br />DENVER <br />CO 80202-5534 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />, <br />Attn: Denver.CertRequest@marsh <br />com ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />. <br />S67982-00125-ALL-09-10 <br /> INSURERS AFFORDING COVERAGE NAIC # <br />INSURED <br />TRAPPER MINING, INC. INSURER A. Great Northern Insurance Company 20303 <br />PO BOX 187 INSURER B: N/A N/A <br />CRAIG, CO 81626 <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. <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT <br />WITH RESPECT TO WHICH THIS CERTIFICATE <br />MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS S <br /> <br />CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY UBJECT TO ALL THE TERMS, EXCLUSIONS AND <br />HAVE BEEN REDUCED BY PAID CLAIMS <br /> <br />NS ADD' . <br /> <br />LTR <br />INSR TYPE OF INSURANCE <br />POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION <br /> DATE(MMIDD/YYYY) DATE(MMMD/YYYY) LIMITS <br /> GENERAL LIABILITY <br /> EACH OCCURRENCE 1,000,000 <br /> <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />37100018 <br />10/01/2009 <br />10/01/2010 DAMAGE T RENTED <br />PR MISESEaocc.'renc. <br />$ 1,000,000 <br /> CLAIMS MADE [X1 OCCUR MED EXP (An <br />one <br /> y <br />person) <br />$ 10,000 <br /> PERSONAL & ADV INJURY $ 1,000,000 <br /> GENERAL AGGREGATE $ 2 <br />000 <br />000 <br /> GENERAL AGGREGATE LIMIT APPLIES PER , <br />, <br /> X POLICY JPE LOC PRODUCTS -COMP/OP AG $ 2,000,000 <br /> <br /> AU TOMOBILE LIABILITY <br /> <br />ANY AUTO COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ <br /> ALL OWNED AUTOS <br /> BODILY INJURY $ <br /> SCHEDULED AUTOS (Per person) <br /> HIRED AUTOS <br /> BODILY INJURY $ <br /> NON-OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE <br /> (Per accident) $ <br /> <br /> GARAGE LIABILITY <br /> <br />F AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: $ <br /> AGG <br /> EXCESS / UMBRELLA LIABILITY <br /> EACH OCCURRENCE $ <br /> OCCUR CLAIMS MADE AGGREGATE $ <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> <br /> WORKERS COMPENSATION AND <br /> <br />EMPLOYERS' LIABILITY WSTATU- OTH- <br />I ER <br />C <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N <br />OFFICER/MEMBER EXCLUDED? ACH ACCIDENT <br />r $ <br /> F N1 <br />(Mandatory in NH) If <br />es <br />describe <br />d SEASE - EA EMPL OYE $ <br /> y <br />, <br />un <br />er <br />SPECIAL PROVISIONS below EAS <br />LDIS <br />E - POLICY LIMIT <br />$ <br /> OTHER <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICL ES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />RE: PERMIT #C-81-010 <br />POLICY INCLUDES COVERAGE FOR PROPERTY DAMAGE AND PERSONAL INJURY RESULTING FROM THE USE OF EXPLOSIVES <br />INSU <br />. <br />RER WILL <br />NOTIFY DIVISION WHENEVER SUBSTANTIVE CHANGES ARE MADE IN THE POLICY INCLUDING ANY TERMINATION <br /> OR FAILURE TO RENEW. <br />CERTIFICATE HOLDER SEA-001494444-19 CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />COLORADO DIVISION OF RECLAMATION EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL WX#4goM MAIL <br />AND SAFETY DEPARTMENT OF NATURAL RESOURCES 30 D <br /> <br />1313 SHERMAN STREET - ROOM 215 AYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />DENVER, CO 80203 9tiC4X 7?x((;yt?{g? <br />XXXDG?C wVxM ("x-%. <br /> TH Q p RE <br />AOf MaRShEUSAPI ne ENTATNE A, .r?CtM2ir»E.?> <br /> <br />Ad1f%0 1 ee rnnnn m?? Sharon A. Hammer <br />@ 1998-2009 ACORD CORPORATION. All Rights Reserved <br />The ACORD name and logo are registered marks of ACORD
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