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APPCOR12579
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APPCOR12579
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Entry Properties
Last modified
8/24/2016 6:32:59 PM
Creation date
11/19/2007 2:32:06 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981011
IBM Index Class Name
Application Correspondence
Doc Date
2/4/1981
Doc Name
CERTIFICATE OF INSURANCE
From
JOHNSON & HIGGINS
Media Type
D
Archive
No
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., <br />! C~OfCJ, <br />'. r ; <br />IIAM[ AhD aDLk[SS O( ALLNIY <br />COMPANIES AFFORDING COVERAGES <br />Johnson tc Higgins of Illinois, Iac. <br />101 South Wacker Drive ;F~~';~"Y ~ Old Republic Co. , <br />Chicago, IL 60606 <br />OOMI'PNy <br />unER <br />I NAMC AND aUDRI SS O( INSIIH(D <br />COM141 NV <br />((III II <br />Sunlaad Mining Corplocatioa -- I <br />P.O. BoZ 55 L, `IAYPNY D <br />1(11111 <br />Oak Creek. Routt County, Colo. ---- <br />__ so4s~ ~('IM1f'~~t"Y E <br />f Thls is to Certlly that poh[ies of msurancc hsled below (lave been scuDd to Ihr Inswed named atmveand -are in lone dr Lhls trmc Nolwdhstandmg any regmrement, Term or condition <br />{ OI any cONrd<l or ogler UOeume0l wpn resEMGI to which Ih6 COrIr D(dlp may Ue r55Ued Or mdy ,%ertaln, the m5urance dHOrdetl Oy IhC DDhcleS tles[rlbed heroin is Sublecl 10 bh INa <br />terms e.cluslOn•. anU cOntlrbons nl sul.h nOhaes. <br /> Limitso Llabili t in Thousan s <br />I IiM Vdr.r <br />LFIIIN III'[ UI IN'J YfFN' I I''ll I, r 6r V.h:r I. PUI ICY <br />1.%PIHAIIDN UPiC (.ACH <br />DCCUARCNCF --- <br />aL(dflWR <br /> GENERAL LIABILITY <br /> tlODILY INJURY i 300 ' boo <br /> fUMPPCH(.NSIVC IURlA <br />~ <br /> f' <br />f <br />u 19drAl$L$_OP(PAnnr,: ZCi 34591 IxiLPI NIY UAMPGC s 300 t. S00 <br /> L V'1 OSIDN <br /> IPIAHD <br />- <br /> l_11,NLrEH~ROUNi, Ilarallu deductible $250 5/1/81 <br /> PIfJUUC 15'CU!tl".1111) <br /> <br />(~7 VPINa110NL IN:/.HD <br />L ILGN n,Ar;lllnl IN\IINRN`I <br /> <br />eapll~aioa deductible P(IDII Y INAIRY ANU <br /> <br />I`HpY1 H1Y nAMn(:1 <br /> <br />s <br /> <br />{ <br /> ~] If l'lJnll I (IIMA I'hl rl'11:1 • $1000 <br />1 I JIAHINCD ~, <br /> II~~II ^nMPLI <br />J u.Ul PI hUI N 1 t <br />UN I unC I Olf. <br />L <br /> . <br />I~ <br />I <br />If~f Pf l'S(INAI RI IIYn _ <br /> <br />PCIt50NPE IN <br /> <br />JURY I <br /> <br />f <br /> AUTOMOBILE LIABILITY uuuhrlN.luler <br />5 <br /> r <br />• <br />I H nCH PEI<$UNI 1 <br /> Lbf.1VP1 HL NLrvI I le~ <br />A <br />I . FGUn_Y tN JURY <br /> UnW U (EACH ACCIDENII <br /> <br />InALU I~ItOPEHIY MMALE t <br /> Hglill Y INIUAY PNU <br /> re df LWrtl b PItUPL If IY DPMPLC f <br /> <br />- n.Jmulruu <br /> _ _ <br />EXCESS LIABILITY <br />~- --~--~~---- - --_,; '--- ~~ ,i- -- - ~ -- <br /> 4 .. " -' (41PrIY INIUNY AND <br /> C] IIMUIQIIA IUIpA 1'HUPERiY UAMALE S t <br /> ril ll[NIH4NIM(IIM1I14 COMDIN(D <br /> (Of!IA ~ "~` 11 <br />_.. _. __ <br />_ <br />_ L~'1 <br />. <br />__ <br /> __ <br />WORKERS' COMPENSATION __ <br />_ <br />_- _ >,rA lurDAr <br /> and <br />' _ <br />!') i''~ ICI /'.Il~i~~.ll! <br />~ f~ <br />~::I::. . <br />I~ <br />f <br /> EMPLOYERS <br />LIABILITV .~ M1Ce4CCIDExr, <br /> OTHER C.~I,i ~~.~ --.'-.-.*t ~ ..'-."" ..' <br />I <br />lE$CHIPIIOx OI OVCRAIIC)N$ l(ICAI IDNi \'CIIKI(S <br />The coepany mill endeavor to mail 10 days written notice to the helot <br />weed certificate holder is the event o! any subataative changes or non- <br />renewal of the policy. <br />Cancellation: Should any ul the ahwe described huhars he cnnceued before the expiration date thereol, the issuing com- <br />pany wdl endeavor to mad ~~ days written notice to the below nameU cer[ilicate holder, but failure to <br />rnall such nohre shall nnpose no ubllE,Jtlon or (lability of any kind upon the company. <br />February ~2 1981 <br />nnn Issul u _.._____ _~-a - <br />$tste of Colorado Dept. of Natural <br />Resources j <br />111aed Land RecLesatioa / ~ ; <br />~ /~', ,~~ <br />._ <br />423 Centennial Bldg. - -- - - - <br />n <br />An <br />hmlyln Itl Px(SFNI ArIVI <br />1813 Shereaa Street <br />Mtnv~tl• 1"re.7w IIARA4 <br /> <br />
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