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GENERAL42715
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GENERAL42715
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Entry Properties
Last modified
8/24/2016 8:11:29 PM
Creation date
11/23/2007 11:56:05 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981014
IBM Index Class Name
General Documents
Doc Date
10/28/2003
Doc Name
Certificate of Liability Insurance
To
DMG
Permit Index Doc Type
Insurance
Media Type
D
Archive
No
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ACORD CERTIFICATE LABI LITY INSURANC~ <br />T5 DA10/27/ <br />) <br />R <br /> ~RG <br />0 <br />1 <br />3 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Brown & Brown Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />7~ <br />Steamboat Spga POB 775043 OC <br />18 O <br />H <br />T F <br />E <br />L <br />X <br />O <br />I <br />2150 Resort Drive, #200 2003 AL <br />TER THE <br />COVERAGE AFFORDED B <br />Y <br />i <br />IC <br />ES BE OW. <br />PO <br />Steamboat Springs CO 80477-5043 <br />Phone: 970-879-1363 Fax:970-879-X2'3®n B! <br />Mineral INSURERS AFFORDING COVERAGE <br />INSURED INS RER A: AmerlCdn Safety Insurance Serv <br /> INSURER B: <br />Energy Fuels Corporation INSURER C: - <br />PO Box 773457 <br />8 <br />77 <br />457 <br />i <br />- INSURER D: <br />-3 <br />- Steamboat Spr <br />ngs CO <br />04 <br /> INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED 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 MAV HAVE BEEN REDUCED BV PAID CLAIMS. <br />ILTR TYPE OF INSURANCE POLICY NUMBER P LI EF IVE <br />GATE MM/DDIYY I Y RATI <br />DATE MM1VDD/YY LIMITS <br /> GENERAL LIABILITY EACHOCCURRENGE $2, OOO, DOD <br />A $ COMMERCIAL GENERAL LIABILITY CML012699001 10/01/03 10/01/04 FIRE DAMAGE (Any onefrel $50, ODD <br /> CLAIMS MADE ®OCCUR MED EXP (Any one person) $10, DOO <br /> PERSONAL BAOV INJURY E 2, ODD, DOD <br /> GENERAL AGGREGATE $ 2, ODD, DDD <br /> GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $2, ODD, OOO <br /> POLICY PRO <br />JECT LOC Em Ben. 2,000,000 <br /> AUT OMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br /> <br />ANV AUTO <br />(Ea acciGent) $ <br />- <br /> i <br />ALL OW NED AUTOS <br /> <br />' <br /> <br />BODILY INJURY <br /> <br />SCHEDULED AUTOS <br />(Per person) $ <br /> HIRED AUTOS <br />BODILY INJURY <br />$ <br /> NON-0W NED AUTOS (Per ac<itlenU <br /> PROPERTY DAMAGE <br /> <br />(Per accitlenp $ <br /> GA RAGE LIABILITY AUTO ONIV-EA ACCIDENT $ <br /> ANV AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG S <br /> EXCESS LIABILITY EACH OCCURRENCE E <br /> <br /> OCCUR ~ CLAIMS MADE AGGREGATE $ <br /> E <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br />"-" WORKERS COMPENSATION"AND'- <br />' ` - -` -°-- - --- -` TORY LIMITS ER <br /> EMPLOYERS <br />LIABILITY <br /> E.L. EACH ACCIDENT $ <br /> E.L. DISEASE-EA EMPLOYEE $ <br /> E.L. DISEASE -POLICY LIMI7 $ <br /> OTHER <br />DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/E%CLUSIONS ADDED BY ENDORSEMENTISPECUIL PROVISIONS <br />RE: Raton Creek Mine - Permit #C-82-055 <br />Kerr Mine -- Permit #C-80-066 <br />Southfield Mine - Permit #C-81-014 <br />Newlin Creek Mine - Permit #C-81-045 <br />V tK11~IVXIC l1VlUCK IN IADDIIIONAL INSURED; INSURER LETTER: L,XKI.CLLNIIVK <br />Colorado Department <br />Natural Resources <br />Division of Minerals <br />1313 Sherman Street, <br />Denver CO 80203 <br />of <br />& Geology <br />Rm 215 <br />CNATIIRA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~~ DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />IMPOSE NOOBLM.ATIO/N~OR!~LIABILITY OF ANY KIND UPON THE INSURER,175 AGENTS OR <br />REPRESENTATIVES. / \I1 <br />
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