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2011-06-29_PERMIT FILE - C1981018A (5)
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2011-06-29_PERMIT FILE - C1981018A (5)
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Last modified
8/24/2016 4:34:58 PM
Creation date
9/13/2011 10:31:59 AM
Metadata
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Template:
DRMS Permit Index
Permit No
C1981018A
IBM Index Class Name
Permit File
Doc Date
6/29/2011
Section_Exhibit Name
Section I. Legal Financial, Compliance and Related Information
Media Type
D
Archive
Yes
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ACORD CERTIFICATE OF LIABILITY INSURANCE DES <br />3 DATE ( o5 <br />ER 9 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Hays Companies HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />80 South 8th Street #700 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />n eapolis MN 55402 <br />ne : 612-333-3323 Fax : 612-373-7270 INSURERS AFFORDING COVERAGE NAIC # <br />ED <br />IR INSURER A: Liberty Mutual Insurance co 23043 <br />Deseret Generation & INSURER B: <br />Transmission <br /> <br />Attn: Robert Dalley INSURER C: <br />10714 South Jordan G teway <br />South Jordan UT 8409 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 <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 />LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE Mf&DD/Y DATE MM DD LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE s2,000,000 <br />A X COMMERCIAL GENERAL LIABILITY TBl-641-436749-028 12/30/08 12/30/09 PREMISES(Eaoccurence) s2,000,000 <br /> CLAIMS MADE X? OCCUR MED EXP (Any one person) $ 10 , 000 <br /> PERSONAL & ADV INJURY $ 2, 000, 000 <br /> X EBL $1,000,000 GENERAL AGGREGATE $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ 2,000,000 <br /> POLICY JERCT 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 person) $ <br /> HIRED AUTOS BODILY INJURY <br />$ <br /> NON-OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE <br /> <br />(Per accident) $ <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGO $ <br /> EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ <br /> OCCUR CLAIMS MADE AGGREGATE $ <br /> <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND <br />' TORY LIMITS ER <br /> EMPLOYERS <br />LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br /> <br />E.L. EACH ACCIDENT <br /> <br />$ <br /> OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ <br /> If yes, describe under <br /> SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ <br /> OTHER <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES! EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS <br />Re: Deserado Mine in Rangely, Colorado (Permit #C-81-018). <br />CERTIFICATE HOLDER CANCELLATION <br />State of Colorado <br />Division of Reclamation, <br />Mining & Safety <br />1313 Sherman Street Room 215 <br />Denver CO 80203 <br />25 (2001/08) <br />COLSTAl SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOP <br />DATE THEREOF, THE ISSUING INSURER WILL -MAIL 30 DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUi <br />1988
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