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GENERAL49603
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GENERAL49603
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Entry Properties
Last modified
8/24/2016 8:29:04 PM
Creation date
11/23/2007 5:14:40 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1996083
IBM Index Class Name
General Documents
Doc Date
6/6/2007
Doc Name
Certificate of Liability Insurance
To
DRMS
Permit Index Doc Type
Insurance
Media Type
D
Archive
No
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+~E~T~Ft~ <br />+~f~ t~F L~AB <br />~o ~ 0; oIYY, <br />I~ <br />TY ~1~~t~R~~~ °fi; 2 , <br /> , <br />, <br />A A <br />/ <br /> P <br />DG <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Bal is Forge Insuraneo Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> of WV, Inc. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> 41 Eagles Road COMPANIES AFFORDING COVERAGE <br /> Beckley WV 25801 COMPANY <br /> (3041 252-6375 /~ Netl Union Fire Ins Co Pgh PA <br /> INSURED RECEIVED COMPANY <br /> Bowie Resources, LLC B <br /> P <br />ANV <br />1500 Bi g'Run Raad. JUN 0620Q7 COM <br /> C <br />' <br />Ashland; KYJ 41102 ' <br /> ;,, , Division oT rteaamauon <br /> , COMPANY <br />Mining and Safety D <br /> COYfR7c(~S `: ? ::: •: <br />-. .,, .:. ... ::: ::: ~ ._._::: .. <br />~: <br />:::::: ': <br />~: <br />. . <br />< <br />ii <br /> _._..... <br />..... <br />.. <br />. <br />..i <br />. <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELO W HAVE BEEN ISSUED 70 THE INSURED NAMED ABOVE FOR THEPOLICY PERIOD <br /> INDICATED,NOTWITHSTANDINGANYREQUIREMEN7,TERMORCONDITION OFANYCONTRACTOROTHER DOCUMENT W ITHRESPECT TO W HICHTHIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> ~ TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION <br />LIMRS <br /> LTR DATE (MMIDDIYY) DATE (MMIDDIYV) <br /> p cE NERALLIABILRY 6464602 5/31/07 5/31/08 GENERAL AGGREGATE S 2,000,000 <br /> X COMMERCIAL GENERAL LIABILITY PRODUCTS~COMP/OP AGO S 1,000,000 <br /> CLAIMS MADE ~ OCCUR PERSONAL 8 ADV INJURY S 1,000,000 <br /> OWNER'SB CONTRAC70A'S PRO7 ~ EACH OCCURRENCE $ 1,000,000 <br /> X Blasting 8 XLU FIRE DAMAGE (Any one lira) 4 1,000,000 <br /> <br /> MED EXP (Any on¢ person) $ 10,000 <br /> AU TOMOBILE LIA80.RY - <br /> COMBINED SINGLE LIMIT 4 <br />~ <br /> ANV AUTO <br /> ALU'OWNED AU70$ BODILY INJURY ' <br /> . -SCHEDULED AUTOS (Per person) S <br /> HIRED AUTOS - - <br />BODILY INJURY <br />g <br /> NON-OWNED AUTOS (Per accitlent) <br /> PROPERTY DAMAGE <br /> g <br /> GARAGE LIABILITY AUTO ONLY ~ EA ACCIDENT $ <br /> ANY AUTO OTHER THAN AUTO ONLY: <br /> EACH ACCIDENT 4 <br /> AGGREGATE 4 <br /> EXCESS LIABILITY EACH OCCURRENCE S <br /> UMBRELLA FORM gGGREGATE $ <br /> OTHER THAN UMBRELLA FORM g <br /> WORKERS COMPENSATION AND WC STATU- OTH~ <br /> EMPLOYERS'LIABILITY TO MITS <br /> <br />R <br />P EL EACH ACCIDENT S <br /> THE P <br />O <br />RIETOR/ <br />PARTNEPS/EXECUTIVE INCL <br />EL DISEASE-POLICY LIMIT <br />S <br /> OFFICERS ARE: E%CL EL DISEASEEA EMPLOYEE Y <br /> OTHER <br /> DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/SPECIAL ITEMS Evi dance of Insurance as re5po<ts Bowie #2 Yine Permit # <br /> 0-096-083. General Liability policy provides prole<tion for use of explosives. <br /> CERTIFICATE HpLRER .. .. .. CANf.ELLAT101V :; . <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> State of Lelorado E%PIRATION DATE TNEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL <br /> Dept of Natural R¢SOUrees 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br /> Olv. of Ni nerols 8 Geology <br />/_ 7__ __~ ~ ]BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABRRY <br />/ <br />~ <br /> r <br />1313 Sherman Stra9t, Room 215 ~ <br />(~ <br />OF ANY KIND UPON THE COMPANY, R8 AGENTS OR REPRE8EN7ATIVEB. <br /> O.nver, co Bozo3 "- ~ "~ - - ~ "°'~~f ~~~U°~CE SE <br />n(~CC'' <br />~~nn <br /> ,, <br />lI ^T~ <br />RVICES <br />~ .HhIF1~{~Nbitl ock, AAI, CPIN <br /> ACORD 25•S 1l9$ :! QA(=,OAO COR.RORATI©rl:IgBB 4 <br />~ <br /> CERTIF KATE: 006/001/ 00009 <br />
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