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GENERAL42503
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GENERAL42503
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Last modified
8/24/2016 8:11:15 PM
Creation date
11/23/2007 11:49:45 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981022
IBM Index Class Name
General Documents
Doc Date
12/20/2004
Doc Name
Certificate of Liability Insurance
To
DMG
Permit Index Doc Type
Insurance
Media Type
D
Archive
No
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1 <br />ACORD CERTIFICATE OF LIABILI TY INSURANCE °"i2i <br />oa <br />s <br /> ~ <br />/ <br />vaooucER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />®, <br />Aon Risk Services RECE9 <br />~® ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />V <br />Z22 LakeVleW AVer1Ue HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />West Palm Beach <br />FL 33401 <br />, <br />DEC 2 0 2004 INSURERS AFFORDING COVERAGE <br />INBDRED INSDRERA: Lexin ton Insurance Com an <br />Oxbow Carbon 8L Minera ; ~ <br />~u ~IdN6i Minerals and GBDI F <br />d <br />l I <br />C <br /> uRER B: <br />e <br />era <br />nsurance <br />om an <br />1601 Forum Place -Suite 1400 INBDRERD: American International S ecial Lines <br />West Palm Beach, FL 33401 INSURER D: <br /> INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED 70 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 BV PAID CLAIMS. <br />INSR rypE OF INSURANCE POLICY NUMBER POLICY EFFECTWE POLICY E%PIRATION LIMRS <br /> GENERAL LIABILRY EACH OCCURRENCE $ 1,00 <br />0,000 <br />A X COMMERCIALGENERALLNBIUTY 0313639 12(1(04 12!1(05 FIRE DAMAGE nyonefire c <br />f SOOOO <br /> CLAIMS MADE ~ OCCUR MED E%P (Any one person) $ <br /> PERSONALBADV INJURY $ 1,000,000 <br /> GENERAL AGGREGATE E 1,000,000 <br /> GEN'L AGGREGATE OMIT APPLIES PER: PRODUCTS-COMPIOP AGG E 1,000,000 <br /> POLICY PRO LOC <br /> AUT OMOBILE LIABILRY COMBINED SINGLE LIMIT E 1 <br />000 <br />000 <br />B X ANV nuro (04)73077258 9/1/04 9/1/05 (Ea accitlenq , <br />, <br /> <br /> ALL OWNED AUTOS <br />BODILY INJURY <br />E <br /> SCHEDULED AUTOS (Per person) <br /> HIRED AUTOS BODILY INJURY <br />E <br /> NON-OWNED AUTOS (Per acdtlenq <br /> PROPERTY DAMAGE <br /> <br />(Per acdtleni) E <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ <br /> ANY AUTO OTHER THAN FA ACC E <br /> AUTO ONLY: AGG $ <br /> EACESS WBILRY EACH OCCURRENCE E 10,000,000 <br />A X OCCUR ~CLAIMSMADE 6478379 12/1/04 12/1/05 AGGREGATE $ 10,000,000 <br /> E <br /> DEDUCTIBLE $ <br /> X RETENTION $ 25 OOO $ <br /> -WORKERB COMPENSATIONANO_-^"' -°-~'~-"--"' - -~ --WOSTATLL -OTH- - - <br /> EMPLOYERS' LWBILRY <br />E.L. EACH ACCIDENT <br />$ <br /> E. L. DISEASE-PA EMPLOYE $ <br /> E.L DISEASE-POLICY LIMIT 8 <br /> OTHER <br />C POLLUTION/ENV IMP PLS 9528238 9/29/03 9/29/06 Aggregate Limit $50,000,000 <br />DESCRIPTION OF OPERATIONSILOCATIONBIVEHICLE3/E%CLUSIONS ADDED BV ENDORBEMENT/BPEGAL PROWSIONS <br />RE: ELK CREEK AND SANBORN CREEK MINES, PERMIT #C-1981-022. COMMERCIAL GENERAL <br />LIABILITY COVERAGE INCLUDES THE USE OF EXPLOSIVES. <br />DIVISION OF MINERALS & GEOLOGY <br />1313 SHERMAN STREET, ROOM 215 <br />DENVER, CO 80203 USA <br />SHOULD ANY OF TXE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TXE E%PIRATON <br />GATE TNEREOF, TXE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O DAYS WRRTEN <br />NOTICE TO THE CERTIFICATE XOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SMALL <br />IMPOSE NO OBLIWTION OR LUI6NJTY OF ANY KIND UPON THE INSURER, RS AGENTS OR <br />Michael J. <br />
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