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2012-10-17_GENERAL DOCUMENTS - C1996084
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2012-10-17_GENERAL DOCUMENTS - C1996084
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Last modified
8/24/2016 5:09:33 PM
Creation date
10/24/2012 8:26:18 AM
Metadata
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Template:
DRMS Permit Index
Permit No
C1996084
IBM Index Class Name
GENERAL DOCUMENTS
Doc Date
10/17/2012
Doc Name
Certificate of Liability Insurance
To
DRMS
Permit Index Doc Type
Insurance
Email Name
LDS
DIH
Media Type
D
Archive
No
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11 a to IrtI( I II I HAI rHt POUCIES 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 />INSit <br />{ TYPE OF INSURANCE 1 ADDL <br />LTR ' iJNSR <br />SUBR <br />IAND <br />POLICY NUMBER <br />POUCY EFF <br />IMM/DDIYYYY) <br />P YP <br />(MMIDD/YYYY) <br />LIFT /TS <br />1 GENERAL LIABILITY <br />-, <br />B X ' COMMERCIAL GENERAL LIABILITY <br />B , <br />GL0011077 - 02 <br />09/23/12 <br />09/23/13 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />DRM S TO RENTED <br />PREMISE (�a ocpar ence) <br />S 100,000 <br />1 1 CLAIMS -MADE LX J� OCCUR <br />MED EM? (Any one person) <br />$ 6,000 <br />L _ _ _ _ _ <br />PERSONAL d ADV INJURY I $ 1,000,000 <br />, X ' Pollution 1 mill <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />' GENT_ AGGREGATE LIMIT APPLIE S PER <br />X POLICY — 173 n LOC <br />PROOUCTS - COMP(OP AGG <br />$ 2,000,000 <br />: <br />AUTOMOBILE LIABILITY <br />1, <br />_ 4 ANY AUTO <br />ALL OWNED f-I SCHEDULED <br />1 AUTOS 4 AUTOS <br />HIRED AUTOS F_, A <br />• 1 1 ' <br />G`\j <br />` ` <br />G <br />� <br />` <br />`0n, <br />COMBINED SINGLE LIMIT <br />(Ea aaddenp <br />$ <br />BODILY INJURY (Per person) <br />$ <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />_ <br />EXCESS UAB B 1 OCCUR <br />I <br />I_ r — _ _ CLAIMS-MADE <br />e dam <br />V \s OF & CJaFP <br />O\ en \� <br />EACH OCCURRENCE <br />AGGREGATE $ <br />` ' DED J I RETENTIONS <br />( <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY N <br />Y <br />N 1 A <br />7 WC STATU- OTH- <br />i TORY LIMITS FR <br />$ <br />E.L. EACH ACCIDENT <br />ANY PROPRIETORRARTNERIEKECUTIVE ` <br />1 1 <br />OFFICER/MEMBER EXCLUDED? I <br />E.L. DISEASE - EA EMPLOYEE <br />S <br />$ <br />(Mandatory in NH) <br />1 N yes describe under <br />1 DESCRIPTION OF OPERATIONS below <br />- <br />E L. DISEASE - POLICY LIMIT I <br />A IEquipment Floater <br />I <br />ILM0300530(EQUIPMENT) <br />12/08/11 <br />12/08/12 <br />DESCRIPTION OF OPERATIONS 1 LOCAT)ONS I VEHICLES (Attach ACORD 101, Additional Reinarks Schedule, M more space Is required) <br />Re: Golden Eagle, Lorencito, and New Elk Mines. <br />a d r o -0C6me 1 <br />ACORLY <br />DATE ($M(DDIYYYY) <br />10/17/12 <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 poficy(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 />Peoples Insurance Agency LLC <br />PO Box 991 <br />Ashland, KY 41105 <br />J. Michael Wellman <br />INSURED New Elk Coal Co. LLC <br />12250 State Highway 12 <br />Weston, CO 81091 -9520 <br />COVERAGES <br />CERTIFICATE HOLDER <br />ACORD 25 (2010/05) <br />NEWEL -2 OP ID: MW <br />CERTIFICATE OF LIABILITY INSURANCE 1 <br />CERTIFICATE NUMBER: <br />606 - 329 -2200 FulriACT <br />606 -325 -77 P Ex* , E: <br />ADDRESS: <br />INSURER(SIAFFOROING COVERAGE <br />INSURER A :RU Insurance Co. <br />NsuRER Insurance Co <br />INSURER C : <br />INSURER D : <br />INSURER E <br />INSURER F : <br />CANCELLATION <br />REVISION NUMBER: <br />FAX <br />(A1C, No): <br />NAIC 1 <br />Colorado Div of Reclamation, <br />Mining, & Safety <br />1313 Sherman Street <br />Room 215 <br />Denver, CO 80203 <br />COLOR -3 <br />SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />- Qr� JNVtw ` +a. <br />©1988 -2010 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />
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