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2010-06-01_GENERAL DOCUMENTS - C1981038
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2010-06-01_GENERAL DOCUMENTS - C1981038
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Last modified
8/24/2016 4:12:33 PM
Creation date
6/2/2010 9:45:15 AM
Metadata
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Template:
DRMS Permit Index
Permit No
C1981038
IBM Index Class Name
GENERAL DOCUMENTS
Doc Date
6/1/2010
Doc Name
Certificate of Liability Insurance
Permit Index Doc Type
Insurance
Email Name
JJD
SB1
Media Type
D
Archive
No
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THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED,NOTWITHSTANDING ANY REQUIREMENT, TERMOR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICHTHIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS <br />LTR DATE (MMIDDIYY) DATE (MM/DDIYY) <br />A GENERAL LIABILITY 6464602 5/31/10 5/31/11 GENERAL AGGREGATE $ <br />X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ <br />CLAIMS MADE 7X OCCUR PERSONAL & ADV INJURY $ <br />WXBlasting NER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ <br />& XCU FIRE DAMAGE (Any one fire) $ <br />MED EXP (Any one person) $ <br />AUT OMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />$ <br /> ANY AUTO <br /> ALL OWNED AUTOS BODILY INJURY <br />(P <br />) $ <br /> SCHEDULED AUTOS er person <br /> HIRED AUTOS BODILY INJURY $ <br /> NON-OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE $ <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO OTHER THAN AUTO ONLY: <br /> EACH ACCIDENT $ <br /> AGGREGATE $ <br /> EXCESS LIABILITY EACH OCCURRENCE $ <br /> UMBRELLA FORM AGGREGATE $ <br /> OTHER THAN UMBRELLA FORM $ <br /> WORKERS COMPENSATION AND <br />- <br />- <br />- - WC STATU• OTH- <br />-TORY _LIMITS -- R _ <br /> EMPLOYERS' LIABILITY EL EACH ACCIDENT $ <br /> THE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT $ <br /> PARTNERS/EXECUTIVE <br />OFFICERS ARE: <br />EXCL <br />EL DISEASE-EA EMPLOYEE <br />$ <br /> OTHER <br />DESCRIPTION OF OPER ATIO N SILO CATION SIVEN ICLESISPECIAL ITEM5 As respects Bowls #2 Mine Permit #C-81-038. General Liability <br />Policy provides protection for use of explosives. Ten days cancellation notice for non-payment of premium. <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />State of Colorado EXPIRATION DATE THEREOF, THE ISSUING COMPANY Wi(XX1%06NOWXXU00dJ KXX <br />Division of Reclamation 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />(dining and Safety )fYDt?tl(AOKMKIEXD(XXMAdKX90DN(XOtImOtKXiElfAIYXMX?(d(YK)Ntl(XiEI(Xd(XXWiI(X8i(XN?tlIKM)FXX <br />1313 Sherman Street, Room 215 OiFXXVKXXMMXXMMXAI((EX)MNWAMXMXX)MK4MXQRXX HHWW6lVWA0X)WCJL <br />Denver, CO 80203 AUTHORIZED REPRESENTATIVE <br />I Adam Rohrig <br />CERTIFICATE: 006/001/ 00046
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