My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
2018-03-01_REVISION - C1981020
DRMS
>
Day Forward
>
Revision
>
Coal
>
C1981020
>
2018-03-01_REVISION - C1981020
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
3/1/2018 11:12:21 AM
Creation date
3/1/2018 11:04:36 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981020
IBM Index Class Name
Revision
Doc Date
3/1/2018
Doc Name
Application
From
CAM Mining, LLC
To
DRMS
Type & Sequence
RN7
Email Name
JHB
Media Type
D
Archive
No
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
9
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
1--"r'4 <br />ACORD' CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DD/YYYY) <br />6/1/2018 1 5/31/2017 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />GUNTAUT <br />PRODUCER LoCkton Companies AX <br />Three City Place Drive, Suite 900 a Nn EXt : ac No): <br />St. Louis MO 63141-7081 E-MAIL <br />(314) 432-0500 ADDRESSa <br />INAFFORDING <br />RECEIVED <br />INSURER A: National Union Fire [ns Co Pitts. PA 119445 <br />INSURED Rhino Resource Partners LP INSURERS: Lexington Insurance Company 19437 <br />1340392 CAM Mining LLC INSURERC: <br />PO Box 1169 JUN Q 9 2017 <br />Pikeville KY 41502 INSURER <br />Division of Redama601111a <br />INSURER E: <br />.. nrtmr t int A'7'1 oevrelnal Lu useen. YYYYYYY <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <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 />IL sR <br />TYPE OF I <br />ADDLNSURANCE IVSD <br />BR <br />POLICY NUMBER <br />POLICY EFF <br />POLICY <br />LIMITS <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE a OCCUR <br />N <br />N <br />3261614 <br />6/1/2017 <br />6/1/2018 <br />EACH OCCURRENCE 2 OOO OOO <br />PR MEET EaETrre.2,000,000 <br />MED EXP (Any oneperson) 10,000 <br />PERSONAL & ADV INJURY $ 2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />POLICY JECT X❑ LOC <br />OTHER <br />GENERAL AGGREGATE $ 2,000,000 <br />PRODUCTS - COMP/OP AGG S 2,000,000 <br />$ <br />A <br />AUTOMOBILE LIABILITY <br />X ANY AUTO <br />AUTOS ONLY SCHEDULED <br />HIRED NON-OVVNED <br />AUTOS ONLY AUT VPN OONLY <br />N <br />N <br />3244251 <br />6/1/2017 <br />6/1/2018 <br />BINentSINGLELIM17 $ 2,000,000 <br />E01 <br />BODILY INJURY (Per person) $ X�X}{J <br />BODILY INJURY (Per accident $ XXXXXXX <br />PPReOP� d Y DAMAGE $ �(}�X <br />$ X)CXXXXX <br />B <br />X <br />UMBRELLA LIAB <br />EXCESS LIAB <br />}{ <br />OCCUR <br />CLAIMS -MADE <br />N <br />N <br />013136615 <br />6/1/2017 <br />6/1/2018 <br />EACH OCCURRENCE $ 5,000,000 <br />AGGREGATE $ 5,000,000 <br />DED I I RETENTION $ <br />Prod Comp Ops $ 5,000,000 <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />ANY PROPRIETORIPARTNERIEXECUTIVE F-7 <br />OFFICERIMEMBER EXCLUDEDI <br />(Mandatory In NH) <br />If e <br />DESCRIPTION OF rPERATIONS below <br />NIAE <br />NOT APPLICABLE <br />STATUTE ER _ <br />rvV <br />L EACH ACCIDENT $ XX)CKXXX <br />sv <br />E L DISEASE . EA EMPLOYEE XXX7xXX <br />E L DISEASE - POLICY LIMIT I Xx�/x <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H more space is required) <br />RE: MUNGER CANYON MINE, DRMS PERMIT 1981-020 <br />GERTIFIGA7E HULUtK a.AlY1+CLLA I IVry <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />11291473 AUTHORIZED REPRESENTATIVE <br />DIVISION OF RECLAMATION <br />MINING AND SAFETY <br />1313 SHERMAN STREET <br />ROOM 215 4w 7 <br />DENVER CO 80203 <br />ACORD 25 (2016103) ©1988- 0- ft—COWORA170N. All rights reserved <br />The ACORD name and logo are registered marks of ACORD <br />
The URL can be used to link to this page
Your browser does not support the video tag.