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2009-11-02_GENERAL DOCUMENTS - C1981028
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2009-11-02_GENERAL DOCUMENTS - C1981028
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Last modified
8/24/2016 3:56:38 PM
Creation date
11/3/2009 10:36:08 AM
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Template:
DRMS Permit Index
Permit No
C1981028
IBM Index Class Name
GENERAL DOCUMENTS
Doc Date
11/2/2009
Doc Name
Certificate of Liability Insurance
To
DRMS
Permit Index Doc Type
Insurance
Email Name
JHB
Media Type
D
Archive
No
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<br />ACORD,M CERTIFICATE OF LIABILITY INSURANCE 11/1/2010 DATE (MM/DD/YYYY) <br />10/30/2009 <br />PRODUCER Lockton Companies <br />LLC Denver THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />, <br />8110 E Union Avenue ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Suite 700 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />CO 80237 <br />D ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />enver <br />(303) 414-6000 <br /> INSURERS AFFORDING COVERAGE NAIC # <br />INSURED Molson Coors Brewing Company INSURER A: Greenwich Iris. Co. <br />1030130 Coors Energy Companyy INSURER B : <br />311 10th•St.ilMail #NH100 <br />CO 80401 <br />Golden <br />INSURER C : <br />, <br /> INSURER D : <br /> INSURER E : <br /> r MITDArT RFTWFFN THE ICCIIINr; <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />ANY REQUIREMENT <br />, <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 />INSR <br />LTR ADDT <br />INSRD <br />TYPE OF INSURANCE <br />POLICY NUMBER POLICY EFFECTIVE <br />DATE (MM/DD/YY) POLICY EXPIRATION <br />DATE (MM/DD/YY) <br />LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1250 000 <br />A X COMMERCIAL GENERAL LIABILITY RGE 943735401 11/1/2009 11/1/2010 PEMS (E. <br />DAMAGE SETo R TEDnce $ XXXXXXX <br /> CLAIMS MADE ? OCCUR MED EXP (Any one person) $ XXXXXXX <br /> X Vendors PERSONAL & ADV INJURY $ 1,250,000 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1250 000 <br /> PRO- <br /> POLICY JECT LOC <br /> <br />A AUT OMOBILE LIABILITY RAG 943735301 11/1/2009 11/1/2010 COMBINED SINGLE LIMIT <br />$ 2 <br />000 <br />000 <br /> X ANY AUTO (Ea accident) , <br />, <br /> G <br /> ALL OWNED AUTOS Q BODILY INJURY $ XXXXXXX <br /> SCHEDULED AUTOS (Per person) <br /> OO?? <br /> X HIRED AUTOS BODILY INJURY $ XXXXXXX <br /> X NON-OWNED AUTOS 01 (Per accident) <br /> z <br />a b! <br /> a <br />J <br />CJa PROPERTY DAMAGE <br />$ XXXXXXX <br /> ` (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ XXXXXXX <br /> ANY AUTO NOT APPLICABLE OTHER THAN EA ACC $ XXXXXXX <br /> AUTO ONLY: AGG $ XXXXXXX <br /> EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ XXXXXXX <br /> 7 OCCUR FICLAIMS MADE AGGREGATE $ XXXXXXX <br /> NOT APPLICABLE $ XXXXXXX <br /> UMBRELLA <br /> 0 <br />DEDUCTIBLE FORM $ XXXXXXX <br /> R XXXXXXX <br />$ <br /> RETENTIeN- -$- - --- -- _ <br /> WORKERS COMPENSATION AND WC STATU- OTH- <br />TORY LIMITS ER <br /> EMPLOYERS' LIABILITY YIN XXXXXXX <br /> ANV PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? NOT APPLICABLE <br /> (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ XXXXXXX <br /> If yes, describe under <br />SPECIAL PROVISIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ XXXXXXX <br /> OTHER <br />DESCRIPTION OF OPERATIONS/LOCATIONSA/EHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />RE: Keenesburg Mine. <br />1439971 <br />Colorado Division of Reclamation, <br />Mining and Safety <br />1313 Sherman Street <br />Room #215 <br />Denver, CO 80203 <br />Almon ie r,3nnofnit <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL K4XEXMXX MAIL 30 DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, X'1X)(n)T?(D(C C }lA`K C <br />AUTHORIZED REPRES T E <br />C <br />arl 9 e La <br />° 1 88-2009 ACORD CO ORATION. All rights reserved <br />The ACORD name and loo are registered marks of ACORD <br />For auestions reaardino this certificate. contact the number listed in the'Pro ucer' section above and soecifv the client code'MOLCOOV.
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