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GENERAL48185
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GENERAL48185
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Entry Properties
Last modified
8/24/2016 8:24:05 PM
Creation date
11/23/2007 4:09:21 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981008
IBM Index Class Name
General Documents
Doc Date
1/5/2001
Doc Name
CERFITICATE OF LIABILITY INSURANCE
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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.II ^11~11~11 ~~~1 ^11 <br />III 1111111111111 III ~RTIFICATE OF LIABILITY INSURANC~ID ~v DATE (MMlDDM') <br />999 STE-1 12/22/01 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />IDS Centerroup, Inc. RECE VEER. TH S CERTIFICATE DOES OT AMENDREIxTEND OR <br />80 South 8th St. , Suite 1650 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Minneapolis MN 55402 <br />Phone:6la-333-3323 JAN 0 2~~~ INSURERS AFFORDING COVERAGE <br />iNSURE° INSURER a: Federal Insurance Comnaav <br />Western Fuels Association, Inc. <br />Attn: Robert Norrgard <br />1100 West 116th Avenue <br />Westminster CO 80234 <br />INSURER C: <br />INSURER D. <br />Iasur once <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 ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />IAAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IG SUBJECT TO ALL THE TERMS, ExCLU510115 AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAV HAVE BEEN REDUCED BY PAID CLAIMS. <br />TR <br />I ODCTIVE <br />TE MM <br />D TION <br />AtEY <br />M <br />U <br />L TYPE OF INSURANCE POLICY NUMBER A <br />/ D <br />M <br />/ <br />D LIMBS <br /> GENERAL LIABILITY EACH OCCURRENCE 5 2, OOO, OOO <br />A X COMMERCIAL GENERALLIABILITV 3710-10-46 O1/O1/Ol 01/01/02 FIRE DAMAGE (anypnarn) s 500,000 <br /> CUIMS MADE OCCUR MED EXP (Hypos person) f lU, DDD <br /> X XCU Coverage PERSONALBADVINJURY S 2, UDU, OOO <br /> GENERAL AGGREGATE S 2, DUD, OOO <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 52, UDD, OOO <br /> POLICY PRO LOC <br />JECT <br /> AUT OMOBILE LUIBILITY COMBINED SINGLE LIMIT <br />S <br /> ANY AUTO (Ea ectldanl) <br /> ALL OWNED AUTOS BODILY INJURY <br />S <br /> SCHEDULED AUTOS (Per parson) <br /> HIRED AUTOS <br />BODILY INJURY <br />S <br /> NON~OWNED AUTOS (Per arcidenl) <br /> PROPERTY DAMAGE <br /> <br />(Per eTCldenl) S <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT f <br /> ANY AUTO OTHER THAN EA ACC S <br /> AUTO ONLY: AGG f <br /> EXCESS LIABILITY CH OCCURRENCE 52S, DUU, DUD <br />H ~ DCCUR ~ CLAIMS MADE <br />' $E 74U 5357 Ul/U1/U1 D1/U1/U2 AOGREGATE f 25, UUD, UDU <br />I mo S <br /> DEDUCTIBLE S <br />~ RETENTION S 5 <br /> WORKERS COMPENSATION AND TORY LIMITS ER <br /> EMPLOYERS' LUBILITY <br /> _ - _ _ _ _ _ _ _ _ _ _ ~ _ E.1. EACH ACCIDENT 5 <br /> E.L. DISEASE-EA EMPLOYE f <br /> E.L. DISEASE-POLICY LIMIT S <br /> OTHER <br />DESCRIPTION OF OPERATIONSILOGATIONSNENIClF.51EXCLU510N5 AOOEO BY ENDORBEMENTISPECIAL PROVISIONS <br />Evidence of insurance ae respects <br />New Horizon Mine in Nucla, CO (Permit #C-81-008) <br />GtK11Y1GAlt KULUtK N ADDITIONAL INSURED; WSURER LETTER. __ GARGCLLAIIVK <br />COLOR-2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE E%PIRATIO <br />Colorado Mined Laad DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O DAY9 WRITTEN <br />Rec 1 ama t i on NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 50 SHALL <br />Mine Land Di Vi e10A IMPOSE NO OBLIGATION OR LIABILITY OF ANY KING UPON THE INSURER, R9 AGENTS OR <br />1313 Sherman Street, RM 215 <br />Denver CO BOZOS REPRESENTATIVES. <br />ACORD 25.5 !7197) <br />
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