Laserfiche WebLink
1>t rY. <br />R ® CERTIFICATE OF LIABILITY INSURANCE DES <br />R- DATE (MMIDD/YYYY) <br />09 <br />? 3 <br />E 12/10/ <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />PRODUCER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Hays Companies HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />E COVERAGE AFFORDED BY THE POLICIES BELOW. <br />t #700 <br />h S <br />h 8 ALTER TH <br />tree <br />t <br />80 Sout <br />Minneapolis MN 55402 <br />Phone: 612-333-3323 Fax: 612-373-7270 0 <br />& <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED \? v INSURER A: Liberty Mutual Insurance Cc 23043 <br />Deseret Generation &\ INSURER 8: E <br />Transmission INSURER C: <br />Attn: Robert Dalley <br />10714 South Jordan Gateway INSURER D: <br />South Jordan UT 84095 <br /> INSURER E: <br />r":..:_.._ <br />l.V V Cr[IiV CJ <br />THE ANY REQUIREMENT T TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICOH T IS CERTIFINDI ICAT ) ITH T? Jety ' <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 />1145 <br />LTR <br />NSR <br />TYPE OF INSURANCE <br />GENERAL LIABILITY <br />POLICY NUMBER <br />-POUCTE <br />DATE MM DD/YYYY <br />DATE MWDD <br />LIMIT <br />EACH OCCURRENCE <br />S <br />s2,000,000 <br /> <br />X <br />MERCIAL GENERAL LIABILITY <br />TBl-641-436749-029 <br />12/30/09 <br />12/30/10 REM <br />PREMISES Eaoccurence> <br />$2,000,000 <br />A COM <br />LAIMS MADE X? OCCUR MED EXP (Any one person) $ 10,000 <br /> C PERSONAL & ADV INJURY $2,000,000 <br /> <br /> X 000 <br />000 <br />EBL $1 GENERAL AGGREGATE $ 2,000,000 <br /> , <br />, <br /> GREGATE LIMIT APPLIES PER: <br />' PRODUCTS - COMP/OP AGG $ 2,000,000 <br /> L AG <br />GEN <br />POLICY PRO LOC <br />JECT <br /> AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT <br />id <br />t <br />E $ <br /> <br />ANY AUTO a acc <br />en <br />) <br />( <br /> ALL OWNED AUTOS BODILY INJURY <br />n <br />P $ <br /> SCHEDULED AUTOS ) <br />( <br />er perso <br /> HIRED AUTOS BODILY INJURY <br />id <br />t <br />P $ <br /> OWNED AUTOS <br />NON er acc <br />en <br />) <br />( <br /> - PROPERTY DAMAGE $ <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> TO OTHER THAN EA ACC $ <br /> ... <br />ANY AU AUTO ONLY: AGG $ <br /> EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ <br /> OCCUR EICLAIMS MADE AGGREGATE $ <br /> <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WOR KER S COMPENSATION <br />j, U TI H- <br />TORY LIMITS ER <br /> AND EMPLOYERS' LIABILITY Y I N <br />ANY PROPRIETOR/PARTNERIEXECUTIVE <br />E.L. EACH ACCIDENT <br />$ <br /> [:] <br />OFFICER/MEMBER EXCLUDED? <br />In NH) <br />M <br />dator <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br /> ( <br />an <br />y <br />If yes, describe under <br />PROVISIONS below <br />SPECIAL <br />?? _? <br />_ - E.L. DISEASE - POLICY LIMIT <br />_ - $ <br />--- - - <br /> _ <br />OTHER <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />Re: Deserado Mine in Rangely, Colorado (Permit #C-81-018). <br />?,crt i ?rrt.r? ? c nvcvcr? - <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> COLSTAl DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />State of Colorado IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />Division of Reclamation, REPRESENTATIVES. <br />Mining & Safety AUTH RIZED REPRESENT I (p <br />1313 Sherman Street Room 215 CW???! <br />14 <br />enver CO 80203 CW <br />All -1-S. <br />ACORD 25 (2009101) --- The ACORD name and logo are registered marks of ACORD