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GENERAL41019
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GENERAL41019
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Entry Properties
Last modified
8/24/2016 8:00:07 PM
Creation date
11/23/2007 10:59:43 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1992080
IBM Index Class Name
General Documents
Doc Date
10/30/2006
Doc Name
Certificate of Liability Insurance
To
DRMS
Permit Index Doc Type
Insurance
Media Type
D
Archive
No
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OAKRENE-01 MORI <br />ACORD,~ CERTIFICATE OF LIABILITY INSURANCE DATE IMMIDDlYYYY) <br /> 10/27/2006 <br />PRODUCER (940) 723-0771 7HIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Allred Thompson Mason Daugherty Ins ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />P O Box 1071 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Wichita Falls, TX 76307-1071 <br /> INSURERS AFFORDING COVERAGE NAIC # <br />INSURED Oakridge Energy Inc; Pueblo Mi In <br />` <br />I <br />' INSURERA: Mid-COntlnent I:asualty CO. <br />4613 Jacksboro Hi hwa ' <br />.. - ' <br />" <br />9 Y ~`'v' INSURERB:Texas Mutual Insurance Co. <br />Wichita Falls, TX 76302- OCT 3 0 2p~6 INSURER C: <br />ra~lOn+ <br />8 INSURER O: <br />Ot ~Gid <br />818ty <br />~V1510n INSURER E: <br />COVERAGES Hurl°~ <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REOUIREMEN7, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR <br />MAV 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 />INSR /1OD'L POLICY NUMBER POLICY EFFECTVE POLICY EXPIRATION LIMITS <br /> GENERAL LIABILITY I EACH OCCURRENCE $ 1x000,00 <br />A X O4GL000655407 12/5/2006 12/5/2007 DAMAGeT~TED 100 <br />00 <br /> COMMERCIAL GENERALLIABILITV PREMISES Ea Occurence x <br />$ <br /> CLAIMS MADE OCCUR MED EXP (Any one person) ~$ EXCLUDE <br /> PERSONALBAW INJURY $ 1,000,00 <br /> GENERAL AGGREGATE S 2x000,OO <br /> GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 2x000+00 <br /> X POLICY PRO LOC <br /> AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT E 1x000,66 <br />A X ANY AUTO 04CA002748328 12/5/2006 12/5/2007 IEa accitlenq <br /> ALL OWNED AUTOS <br />BODILY INJURY <br />S <br /> X SCHEDULED AUTOS (Per person) <br /> X HIRED AUTOS <br />BODILY INJURY <br /> X NON-0WNED AUTOS (Per acdtlent) $ <br /> A~GE <br /> ) E <br /> (Per accitlent <br /> GARAGE LIABILnY AUTO ONLY-EA ACCIDENT $ <br /> ANYAUTO OTHER THAN EA ACC I $ <br /> AUTO ONLY: AGG $ <br /> EXCESSNMBRELU LIABILITY EACH OCCURRENCE $ 1x000,00 <br />A OCCUR ~ CLAIMSMADE 04X$147120 12/5/2006 12/5/2007 AGGREGATE $ 1x000,00 <br /> <br /> DEDUCTIBLE E <br /> X RETENTION E 10,000 $ <br /> WORKERS COMPENSATON ANO I y I OBGTY LATUS~OER <br />L=1-T <br />B EMPLOYERS'LIABILITY <br />ANV PROPRIETORIP <br />ERIE%EC <br />E SBP0001027321 7/14/2006 7/14/2007 <br />E.L. EACH ACCIDENT 500x00 <br />S <br /> ARTN <br />UTIV <br />OFFICER/MEMBER EXCLUDED? <br />E.L. DISEASE - EA EMPLOVEE~. SOO,OO <br />E <br /> ttyes, tlescribe untler ~ 00 <br />500 <br /> SPECIAL PROVISIONS belov I E.L. DISEASE-POLICY LIMIT , <br />E <br />~ OTHER <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />Carbon Junction Coal Mine, Durango, Colorado Permit #C-92.080 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI <br />Colorado Division of Minerals & Geology DATE THEREOF, THE ISSUING INSURER WILIX~S~L MAIL 3O <br />1313 Sherman Room 215 DAYS VmITTEN <br />Denver, CO 80203-0000 NOnCE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, ILNJflllil(Olltltld6)6)t74MLL <br />AUTHORIZED REPRESENTATIVE <br />eT-1 <br />25 <br />
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