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GENERAL41839
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GENERAL41839
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Entry Properties
Last modified
8/24/2016 8:10:14 PM
Creation date
11/23/2007 11:27:09 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981025
IBM Index Class Name
General Documents
Doc Date
7/13/2006
Doc Name
Certificate of Liability Insurance
To
DMG
Permit Index Doc Type
Insurance
Media Type
D
Archive
No
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ACORD CERTIFICATE OF LIABILI7Y~SURANCE OP ID DnrE (MnvoomrY) <br />SEMCO-1 06 30 06 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />HDB International Southwest ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Blanchard Iasurance Group HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />P . O. Box 60130 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Grand Junction CO 81506 <br />O <br />Phone: 970-245-8011 Fax: 970 -245-SOH INSURERS AFFORDING COVERAGE NAIC# <br />INSURED ~ ~ INSURER A: Em 10 Era Mutual Casualt C <br />'° <br />6 <br />t) <br />p0 INSURER B: <br />1 ~ <br />$SM Cona r11CtiOn CO. ~\~~ <br />L INSURER C: <br />, <br />627 24 1~2 Rd, IInit Ir <br />G <br />d J <br />C <br />81505 <br />i <br />A INSURER D: <br />raa <br />on <br />unct <br />G <br />Y B^ <br />'_ INSURER E: <br />COVERAGES ~a~`"` ~~ <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE 8 EN ISBUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANV CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAV BE ISSUED OR <br />MAY PERTAIN. THE INSURANCE AFFORDED BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BV PAID CLAIMS. <br />LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD DATE MM ODIYY LIMffS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1 ~ OOO r OOO <br />A X COMMERCIAL GENERAL LIABILITY 9X90868 05/10/06 05/10/07 PREMISES (Eaoccurence) S100r000 <br /> CLAIMS MADE ~ OCCUR - MED EXP (Any one person) $ 5 ~ OQO <br /> PERSONAL 8 ADV INJURY $ 1 r OOO r OOO <br /> GENERAL AGGREGATE E1 r OOO ~ OOO <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS ~ COMP/OP AGG E 2 r OOO ~ OOO <br /> POLICY PRO- LOC <br />JECT <br /> AUT OMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />E 1 OOO OOO <br />r <br />A X ANY AUTO 9X90868 05/10/06 05/10/07 (Eaacddenq <br /> ALL OWNED AIfTOS <br />BODILY INJURY <br />$ <br /> SCHEDULED AUTOS (Per person) <br /> X HIRED AUTOS BODILY INJURY $ <br /> X NON-0WNED AUTOS (Per accident) <br /> PROPERTY DAMAGE <br /> <br />(Per acddent) E <br /> GARAGE LIABWTY AUTO ONLY-EA ACCIDENT E <br /> ANV AUTO OTHER THAN EA ACC E <br /> AUTO ONLY: AGG E <br /> EXCESSNMBRELLA LIABILITY EACH OCCURRENCE E <br /> OCCUR ~ CLAIMS MADE AGGREGATE E <br /> E <br /> DEDUCTIBLE E <br /> RETEMION $ E <br /> WORKERS COMPENSATION AND TORY LIMITS ER <br /> EMPLOYERS'LIABILHY -.- <br /> ANY PROPRIETORIPARTNERlEXECUTIVE _ _ _ _ <br />~ __ _ E.L. EACH ACCIDENT E <br /> OFFICER/MEMBER EXCLUDED? EL. DISEASE - EA EMPLOYEE $ <br /> I( es, tlescdbe antler <br /> SPECIAL PROVISIONS below E.L. DISEASE-POLICY LIMIT E <br /> OTHER <br />DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS <br />Re: North Thompson Creek-File No C-81-025. State OE Colorado, Division Of <br />Minerals & Geology is included~as an Additional Insured.*10 Days Notice due <br />to Non-Paymeat Of Premium.**Or incur substantive changes or failure to <br />renew. <br />CERTIFICATE HOLDER CANCELLATION <br />0000000 SHOULD ANY OF THE ABOVE DESCRIBED POl1CIES BE CANCELLED BEFORE THE EXPIRATION <br />State Of COl OradO GATE THEREOF, THE ISSUING INSURER WILL afm3RI~S~MAIL *3O DAYS WRITTEN <br />Division Of Minerals GEt01Ogy NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />1313 Sharman Street Room 215 ~~,jJ <br />Denver CO 80203 ww <br />accnisirarwwvEe- <br />AUTHORIZED REPRESENTATNE ~ <br />Viraine Kornbluth i~~~I/ii'G9' ~ /~G//U/~ <br />
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