My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
2018-07-11_GENERAL DOCUMENTS - C1981041
DRMS
>
Day Forward
>
General Documents
>
Coal
>
C1981041
>
2018-07-11_GENERAL DOCUMENTS - C1981041
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
7/12/2018 10:50:40 AM
Creation date
7/12/2018 7:09:35 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981041
IBM Index Class Name
General Documents
Doc Date
7/11/2018
Doc Name
Certificate of Insurance
To
DRMS
Email Name
CCW
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.
/
2
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
® DATE(MM/DD/YYYY) <br /> A�o CERTIFICATE OF LIABILITY INSURANCE 06/28/2018 <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 /> PRODUCERAC <br /> NAME: <br /> MCGRIFF,SEIBELS&WILLIAMS,INC. PHONE FAX <br /> P.O.Box 10265 (AIC, <br /> C No gp0 476.2211 Ext): A/C No): <br /> Birmingham,AL 35202 E-MAIL <br /> ADDRESS: <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A ACE American Insurance Company 22667 <br /> INSURED INSURER B: <br /> American Electric Power Company,Inc.and all Subsidiaries <br /> 1 Riverside Plaza INSURER C: <br /> Columbus,OH 43215 <br /> INSURER D <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:D8JU3N6Y REVISION NUMBER: <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 /> INSR TYPE OF INSURANCE ADD SUBR POLICY EFF POLICY EXP <br /> LTR INSD WVD POLICY NUMBER MMIDD MM/DD LIMITS <br /> • X COMMERCIAL GENERAL LIABILITY HDO G71097055 07/01/2018 07/01/2021 EACH OCCURRENCE $ 1,000,000 <br /> DAMAGETORENTED X CLAIMS-MADE �OCCUR PREMISES Ea occurrence $ 1,000,000 <br /> MED EXP(Anyone person) $ <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> X POLICY❑PRO ❑LOC PRODUCTS-COMP/OPAGG $ 2,000,000 <br /> JECT <br /> OTHER: $ <br /> A AUTOMOBILE LIABILITY ISA H25159792 07/01/2018 07/01/2021 COMBINED SINGLE LIMIT 1,000,000 <br /> Ea accadent <br /> X ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> X AUTOS ONLY X AUTOS ONLY Per accident <br /> I <br /> UMBRELLA LIABOCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE ^�`� AGGREGATE $ <br /> DED RETENTION$ v $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY YIN1 TAME ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE `\� `� a�` �� E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED N/A \v O --- <br /> (Mandatory in NH) S �'am E.L.DISEASE-FA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below O� 'd�e E.L.DISEASE-POLICY LIMIT $ <br /> $ <br /> $ <br /> $ <br /> $ <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) <br /> Named insured includes Snowcap Coal Company,inc. Covers all operations in the State of Colorado,X,C,U included. <br /> Endorsement Cancellation Notice: <br /> In the event we cancel this policy,we agree to mail prior written notice of cancellation to the name and address shown in the schedule below. The number of days of <br /> advance notice of cancellation sent to the names shown In the schedule shall be equal to or greater than the statutory requirement and can never be less than the <br /> mandated period. <br /> Schedule <br /> (continued next page) <br /> CERTIFICATE HOLDER CANCELLATION <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 /> Colorado Department of Natural Resources <br /> Division of Reclamation,Mining and Safety <br /> 1313 Sherman Street-Room 215 AUTHORIZED REPRESENTATIVE <br /> Denver,CO 80203 <br /> United States <br /> Page 1 of 2 ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) 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.