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2008-03-05_REVISION - C1981035
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2008-03-05_REVISION - C1981035
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Entry Properties
Last modified
8/24/2016 3:24:31 PM
Creation date
1/31/2011 12:41:29 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981035
IBM Index Class Name
REVISION
Doc Date
3/5/2008
Doc Name
Response Letter & Enclosed Liability Insurance Certificates
From
GCC Energy
To
DRMS
Type & Sequence
SO3
Media Type
D
Archive
No
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_ <br />ACORD„ CERTIFICATrli DATE(MM/DD/YYYY) <br />i)(INSURANCE 03/04/2008 <br />PRODUCER Q <br />Inc. <br />Aon Risk services southwest <br />5 2008 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY <br />, <br />MAR O <br />fka Aon Risk services of Texas, Inc. AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />1330 Post Oak Blvd. CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE <br />Suite 900 Din -; nn of r" eCi:3nlati0 OVERAGE AFFORDED BY THE POLICIES BELOW. <br />Houston Tx 77056-3089 USA N, ;o; ng and Safety <br /> INSURERS AFFORDING COVERAGE NAIC # <br />PHONE-(866) 283-7122 FAx- 847 953-5390 <br />URED <br />N INSURER A: National Union Fire ins Co of Pittsburgh 19445 <br />I <br />S <br />GCC Energy, LLC INSURERS: Liberty Insurance Underwriters, Inc. 19917 <br />4424 County Road 120 <br />Hesperus CO 81326 USA 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. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY <br />PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. <br />AGGREGATE LBVHTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR J <br />LTR ADD'14 <br />INS <br />TYPE OF INSURANCE <br />POLICY NUMBER POLICY EFFECTIVE <br />DATE(MM\DD\YY) POLICY EXPIRATION <br />DATE(MM\DD\YY) <br />LIMITS <br />A GL 4807161 09/01/07 09/01/08 EACH OCCURRENCE $1,000,000 <br /> EN <br />X ERAL LIABILITY DAMAGE TO RENTED $50,000 <br /> COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurence) <br /> CLAIMS MADE ® OCCUR one peusoo <br /> PERSONAL & ADV INJURY $1,000,000 <br /> GENERAL AGGREGATE $2 , O00 , OOO <br />' <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $2,000,000 <br /> <br /> ?x POLICY PRO- ? LOC <br />JECT <br />A AUTOMOBILE LIABILITY CA 4806652 09/01/07 09/01/08 COMBINED SINGLE LIMIT <br /> (Ea accident) $1,000,000 <br /> X ANY AUTO <br /> <br /> ALL OWNED AUTOS BODILY INJURY <br /> x SCHEDULED AUTOS ( Per Pe-n) <br /> <br /> x HIRED AUTOS BODILY INJURY <br /> NON OWNED AUTOS (Per accident) <br /> $1000 Coll Ded PROPERTY DAMAGE <br /> (Per accident) <br /> $1000 CaoD Ded <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT <br /> ANY AUTO OTHER THAN EA ACC <br /> 8 AUTO ONLY <br />AGG <br />B EXCESS /UMBRELLA LIABILITY LQ167118356504 09/01/07 09/01/08 EACH OCCURRENCE <br /> OCCUR 1:1 CLAIMS MADE umbrella Liability Prim AGGREGATE $10,000,000 <br /> Products/Completed o $10,000,000 <br /> DEDUCTIBLE <br /> B <br />RETENTION <br />A <br /> <br />WORKERS COMPENSATION AND WC7208638 <br />9 <br />x <br />WC STATU- <br />OTH- <br /> EMPLOYERS' LIABHdTY E.4 EACH ACCIDENT $1,000,000 <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE <br />E.LDISEASE-EA EMPLOYEE <br />$1,000,000 <br /> OFFICER/MEMBER EXCLUDED? <br /> If yes, descnbe under SPECIAL PROVISIONS E.L. DISEASE-POLICY LIMIT $1,000,000 <br /> below <br /> OTHER <br />DESCRIPTION OF OPERATIONS/I.OCATIONS/VEHICLES/EXCLUSIGNS ADDED BY ENDORSEMENT/sPECIAL PROVISIONS <br />Re: OSM Permit CO-0106, and CDRMS Permit CO-1981-035 <br />Marc and Julie Crawford are named as Additional Insureds as required by written contract but limited to the <br />operations of the insured under said contract, and always subject to the policy terms, conditions and exclusions. <br />CERTIFICA'T'E HOLDER CANCELLATION <br />Marc and Julie Crawford SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />2323 County Road 121 DATE THEREOF, THE ISSUING INSURER WILL END&WO FT9 MAIL <br />Hesperus CO 81326 USA 30 DAYS WRITTENNOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />' B Eily 98 AGEPWS OR RHPR&SBNTATPA9& <br /> AUTHORIZED REPRESENTATIVE <br /> <br />25 (2001/081 ACORD CORPORATION 1988 <br />ACORD <br />a <br />^a <br />d <br />'L7 <br />O <br />x <br />0 <br />z <br />utt <br />v <br />L <br />d <br />U <br />
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