My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
2011-10-11_GENERAL DOCUMENTS - C1981010
DRMS
>
Day Forward
>
General Documents
>
Coal
>
C1981010
>
2011-10-11_GENERAL DOCUMENTS - C1981010
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
8/24/2016 4:43:55 PM
Creation date
10/11/2011 10:23:58 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981010
IBM Index Class Name
GENERAL DOCUMENTS
Doc Date
10/11/2011
Doc Name
Certificate of Liability Insurance
To
DRMS
Permit Index Doc Type
Insurance
Email Name
RDZ
Media Type
D
Archive
No
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
2
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
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, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <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 />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INSR <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />(MM /DD/YYYY) <br />POLICY EXP <br />(MM /DD/YYYY) <br />LIMITS <br />A <br />GENERAL <br />X <br />LIABILITY <br />COMMERCIAL GENERAL LIABILITY <br />INSURED <br />TRAPPER MINING, INC. <br />PO BOX 187 <br />CRAIG, CO 81626 <br />INSURER B : N/A <br />35907412 <br />�j ® <br />10/01/2011 <br />10/01/2012 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />DAMAGE TO RENTED <br />PREMISES (Ea occurrence) <br />1,000,000 <br />$ <br />MED EXP (Any one person) <br />$ 10,000 <br />CLAIMS -MADE <br />X <br />OCCUR <br />PERSONAL & ADV INJURY <br />$ 1,000,000 <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />PRODUCTS - COMP /OP AGG <br />$ 2,000,000 <br />GEN'L AGGREGATE <br />7 1 POLICY <br />LIMIT APPLIES <br />PRO IF1T <br />PER: <br />LOC <br />$ <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO- <br />V <br />� �` C <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />BODILY-INJURY leer nersonl <br />_$ <br />$ <br />$ <br />BODILY INJURY (Per accident) <br />(`T 1 12011 <br />QC <br />:cv°C1amaO�' <br />p1v►SIUI` ti Safeh <br />AUTOS <br />HIRED AUTOS <br />_ <br />SCHEDULED <br />AUTOS <br />NON -OWNED <br />AUTOS <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />$ <br />UMBRELLA LIAR <br />EXCESS LIAB <br />OCCUR <br />OCCUR <br />CLAIMS -MADE <br />fln <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />$ <br />DED <br />I RETENTION $ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />ANY PROPRIETOR /PARTNER /EXECUTIVE <br />OFFICER /MEMBER EXCLUDED? f N <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N / A <br />WC STATU- <br />TORY LIMITS <br />OTH- <br />FR <br />E.L. EACH ACCIDENT <br />$ <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />RE: PERMIT #C-81-010 <br />POLICY INCLUDES COVERAGE FOR PROPERTY DAMAGE AND PERSONAL INJURY RESULTING FROM THE USE OF EXPLOSIVES. <br />ACORD <br />® CERTIFICATE OF LIABILITY INSURANCE <br />`....∎ -- <br />DATE /YYYY) <br />10103//2011 2011 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />MARSH USA INC. <br />1225 17TH STREET, SUITE 2100 <br />DENVER, CO 80202 -5534 <br />Attn: Denver.CertRequest@marsh.com / FAX 212 -948 -4381 <br />S67982 00125 - ALL - 11 - 12 <br />CONTACT <br />PHONE FAX <br />(A/C. No. Fad): (A/C. No): <br />E - MAIL <br />ADDRESS. <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURER A : Federal Insurance Company <br />20281 <br />INSURED <br />TRAPPER MINING, INC. <br />PO BOX 187 <br />CRAIG, CO 81626 <br />INSURER B : N/A <br />N/A <br />INSURER C : <br />INSURER D : <br />INSURER E : <br />INSURER F : <br />COVERAGES <br />CERTIFICATE HOLDER <br />CERTIFICATE NUMBER: <br />SEA 002108815 - 24 <br />CANCELLATION <br />REVISION NUMBER: 5 <br />COLORADO DIVISION OF RECLAMATION <br />AND SAFETY DEPARTMENT OF NATURAL RESOURCES <br />1313 SHERMAN STREET - ROOM 215 <br />DENVER, CO 80203 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />of Marsh USA Inc. <br />Sharon A. Hammer <br />ACORD 25 (2010/05) <br />© 1988-2010 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />
The URL can be used to link to this page
Your browser does not support the video tag.