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2009-09-21_PERMIT FILE - C1981010A (47)
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2009-09-21_PERMIT FILE - C1981010A (47)
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Entry Properties
Last modified
8/24/2016 3:55:40 PM
Creation date
11/24/2009 12:51:33 PM
Metadata
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Template:
DRMS Permit Index
Permit No
C1981010A
IBM Index Class Name
Permit File
Doc Date
9/21/2009
Section_Exhibit Name
1.0 Introduction
Media Type
D
Archive
Yes
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Av d CERTIFICATE OF LIABILITY INSURANCE <br /> <br />DATEIMM1VDDYYYV <br />I <br /> 10/01/2009 <br />PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION <br />F?QE H USA INC. <br />M ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />A <br />1225},'17TH STREET, SUITE 2100 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />DENSSER, CO 80202-5534 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Attn: Denver.CertRequest@marsh.com <br />i <br />S67982-00125-ALL-09-10 INSURERS AFFORDING COVERAGE NAIC # <br /> <br />INSURED <br />TRAPPER MINING <br />INC <br />- <br />?% INSURER A: Great Northern Insurance Company 20303 <br />, <br />. <br />•, <br />\„ <br />INSURER B: <br />N/A <br />PO BOX 187 N/A 1- ...?? <br />CRAIG, 0081626 <br />; <br />\ ', <br />,e1 INSURERC: <br />\ <br />\ <br />? <br /> INSURER D: 0 i ' ?nn <br />/ ,).,,C'? ,\?• )..``\\,?\'T INSURER E' n.. <br />PAVFRAFiFS` .D- . ' - - _. ....civil, v <br />- - - r, ^ THE POLICIF <br />S,?OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. <br />? <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE <br />MAY BE ISSUED OR MAY:PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND <br />CONDITIONS OF, SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />NSR AOD'U TYPE OF INSURANCE POLICY NUMBER POLICY EFFEDTNE PDUCY E%PIRATION <br />' LIMITS <br />LTRI INSRd DATENIMDD/YYYY) DATE(MMIDDA <br />YYY) <br /> GENERAL LIABILITY EACH OCCURRENCE i 000 000 <br /> DAMAGE <br />TO <br />RENTED $ 1 <br />000 <br />000 <br />A X COMMERCIAL GENERAL LIABILITY 37100018 10/01/2009 10/01/2010 occurrence <br />PREMISE <br />S <br />Ea , <br />, <br /> Ix I MED EXP(Arry one person) $ 10 <br />000 <br /> CLAIMS MADE <br />OCCUR , <br /> 1 PERSONAL&ADV INJURY $ 1,000,000 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> <br /> GENERAL AGGREGATE LIMIT APPLIES PER <br /> <br />PRO- PRODUCTS- COMP/OP AG <br />0 <br />2,000,00 <br /> X . POLICY JECT LOC <br /> AUT OMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />$ <br /> ANY AUTO (Ea accident) <br /> ALL OWNED AUTOS BODILY INJURY $ <br /> SCHEDULED AUTOS (Per perm) <br /> <br /> HIRED AUTOS BODILY INJURY $ <br /> NON-OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE <br />Per accident) <br />$ <br /> ( <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO OTHERTHAN EAACC $ <br /> H AUTO ONLY: $ <br /> AGG <br /> EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ <br /> OCCUR CLAIMS MADE AGGREGATE $ <br /> <br /> DEDUCTIBLE <br />$ <br /> RETENTION $ <br /> WORKERS COMPENSATION AND WC STATU- OTH- <br /> ' <br /> EMPLOYERS <br />LIABILITY <br />$ <br /> ANY PROPRIETOR/PARTNERIEXECUTIVE Y/N L. EACH ACCIDENT <br /> OFFICER/MEMBER EXCLUDED? <br />.L. DISEASE-EA EMPLOYE <br />$ <br /> (Mandatory in NH) Hyes. describe under <br />L DISEASE - POLICY LIMIT <br /> SPECIAL PROVISIONS belay <br /> OTHER <br />DESCRIPTION OF OPERATION&rLOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS <br />RE: PERMIT#C-81-010 <br />POLICY INCLUDES COVERAGE FOR PROPERTY DAMAGE AND PERSONAL INJURY RESULTING FROM THE USE OF EXPLOSIVES. INSURER WILL <br />NOTIFY DIVISION WHENEVER SUBSTANTIVE CHANGES ARE MADE IN THE POLICY INCLUDING ANY TERMINATION 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 IOJQ(fP MAIL <br />AND SAFETY DEPARTMENT OF NATURAL RESOURCES 30 DAYSWRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMEDTO THE LEFT, <br />1313 SHERMAN STREET- ROOM 215 <br />DENVER, CO 80203 ?uC?gN}80?NTNO?XXXC6XIKLX9CCMAONYA10 <br />OC <br />X <br />XDD(XX)(MRf61DBXXX)CKXXXOg31A04 X)OwIXX)(OOQK )WJO6TFM. <br />k*06 <br /> g <br />g <br />[ <br />AOr MCRIIEUSAPIrICENTATtVE _ R4a-??v -?Ci/>'+'t/??1EiJ <br /> Sharon A. Hammer <br />ACORD 25 (2009101 <br />© 1998-2009 ACORD CORPORATION. All Rights Reserved <br />The ACORD name and logo are registered marks of ACORD <br />I- Cl I ?l21 ?0`?
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