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2009-01-26_GENERAL DOCUMENTS - C1981015
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2009-01-26_GENERAL DOCUMENTS - C1981015
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Last modified
8/24/2016 3:43:05 PM
Creation date
3/30/2011 9:31:15 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981015
IBM Index Class Name
GENERAL DOCUMENTS
Doc Date
1/26/2009
Doc Name
Last Call Fruita Mine PKA 9-1149 (Part 1 of 2)
From
AML
Permit Index Doc Type
Reclamation Projects
Media Type
D
Archive
No
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Pinnacol Assurance <br />DATE (MWDD/YYYY <br />CERTIFICATE OF LIABILITY INSURANCE 02/24/2009 <br />LY <br />/?zI <br />ACQRQTN <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ON <br />ER. THIS <br />AND CONFERS <br />ICATE DOES NOT AMEND, EXTEND ORIA TER THE <br />CERTIFICATE <br />COVERAGE AFFORDED BY THE POLICIES BELOW. <br />INSURERS AFFORDING COVERAGE NAIC# <br />INSURERN PINNACOL ASSURANCE 41190 <br />INSURER E: <br />PINNACOL ASSURANCE <br />7501 E Lowry Bbd <br />Denver, CO 80230-7006 <br />INSURED <br />K & P PROPERTY DESIGNS <br />236S3RD#219 <br />MONTROSE, CO 81401 <br />INSURER D: <br />INSURER E: <br />:: -WITHSTANDNG <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. BE ISSUED OR <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />ll PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLIC LIM <br />IES ITS SHOWN MAY HAVE BEEN HEUUUr-U 01 rriv v? •••? N <br /> . POLICY EFFECTIVE POLICY EXPIRATIO <br />INSR ADD'L <br />POLICY NUMBER <br />DATEIMM/DD/YYYY) pATE(MMlDplV VVV) LIMIT S <br />LTR IN9R0 TYPE OF INSURANCE EACH OCCURRENCE <br /> GENERAL LIABILITY DAMAGE TO RENTED <br /> COMMERCIAL GENERAL LIABILITY PREMISES <br /> <br /> CLAIMS MADE 11 OCCUR MED EXPIAny One 15e150n1 <br /> PERSONAL&ADV INJURY <br /> GENERAL AGGREGATE <br /> GE N'L AGGREGATE LIMIT APPLIERS PER: PRODUCTS - COMPIOP AGO <br /> POLICY PROJECT LOC <br />COMBINED SINGLE OMIT <br /> <br /> AUTOMOBILE LIABILITY <br />(E a Accident) <br /> ANY AUTO BODILY INJURY <br /> ALL OWNED AUTOS tperpemon) <br /> SCHEDULED AUTOS BODILY INJURY <br /> HIRED AUTOS IPer accidenp <br /> NON•OWNEO AUTOS PROPERTY DAMAGE <br /> {P er acc (dent) <br /> AUTO ONLY - EA ACCIDENT <br /> <br /> GARAGE LIABILITY OTHER THAN EA ACC <br /> <br /> ANY AUTO AUTO ONLY: AO <br /> EACH OCCURRENCE <br /> EXCESSIUNBRELLA LIABILITY AGGREGATE <br /> OCCUR CLAIM9 MADE <br /> <br /> DEDUCTIBLE <br /> RETENTION a <br />X WC3TATU• OTHER <br /> <br /> WORKERS COMPENSATION AND <br />TORY LIMITS <br />A EMPLOYER'S LIABILITY 4090698 04/01/2008 04/01/2009 <br />E.LEACHACCIDENT <br />$500,000 <br /> ANY PROPRIETORIPARTNERIEXECUTIVE <br /> E.LDISEASE-EA EMPLOYEE $500,000 <br /> OFFICER/MEMBER EXCLUDED' <br />DISEASE- POLICY LIMIT <br />50D 000 <br /> lease de%Crlbe under SPECIAL PROVISIONS below <br />It E.L <br /> yes, p <br /> OTHER <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS AUULU UT crvuvnaoa?•..?.-??•--• •-- - -. - <br />CERTIFICATE HOLDER <br />1135886 <br />dividion of reclamation mining <br />and safety <br />1313 Shermand street #215 <br />denver CO 80203 <br />ACORD 25(2001/08) <br />CANCELLATION <br />SFIVULLJJY11T yr <br />THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR T <br />MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO TH <br />LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR <br />LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR <br />REPRESENTATIVES. <br />AUTHORIZED REPRESENTATIVE <br />My Dung Cao <br />Underwriter <br />PAGE 2 OF 3 <br />ACORD CORPORATION 1988
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