My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
APPCOR13187
DRMS
>
Back File Migration
>
Application Correspondence
>
3000
>
APPCOR13187
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
8/24/2016 6:33:27 PM
Creation date
11/19/2007 2:39:05 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1984067
IBM Index Class Name
Application Correspondence
Doc Date
6/20/1985
Doc Name
INSURANCE BINDER
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.
Page 1 of 1
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 <br />~~ 'II'II'I'II"II"I' ~ / ~ ~ <br />': - <br />e~nper0014 1 <br /> . r <br />. <br />ffff <br /> varaE nNp app PEES OE nGENCr COMPANY <br /> INLAND INSURANCE AGIIVCY BITUMINOUS INSURANCE COMPANY <br /> DURANGO OFFICE <br /> 147~r-pdAIN AVEfdUE, SUITE 108 Eltectrve i S*r - ,1 <br />prres- -~-t2:Ot am Q <br />E <br />x <br />2='30-1~rS- 7 <br /> 01 <br />DURA~O <br />COLORADO 81 NOO <br /> , <br />3 ]] <br />cc <br />~~~ <br /> LS,his border is issued to extend coB agenrn~the,a DOOveO J~amed <br /> company per eaprrrng policy t1 ~ jf U <br /> em as poi=o ce~o x, <br /> NaraE / ND M>IEING 4DDRE ES Of INSURED Description of Operation! Vehicles! Property <br /> PEERLESS RESOURSES <br />INC. MINE LOCATED 4 B(ILES WEST OF DURAP(GO <br /> . <br />5528 INDIATd ROCK ROAD LA PLATA COUNTY <br /> SALT LAKE CITY. UTAFI 84117 DURANGO, COLORADO 81301 <br />P <br />a <br /> <br />- Type and Location of Property CoveragelperilslForms Amt al Insurance Ded. CO.';a <br /> <br />- ,. <br />~ '1 ~.. ' L. d ~ <br /> D I <br /> H <br />_ ° ~UL 1? <br /> P <br /> E <br /> <br /> Y <br />i:olC ~fj,' p ?;B:ufei ~ <br />;ours ~: <br /> f I <br />T I ! F <br />C Limits of Liability ~ <br /> nsurance <br />ype o overage <br />orms <br /> Each Occurrence Aggregate I <br /> L <br />I II~~ <br />LJ SGhetluled Form ^ Comprenensrve Form <br />Bodily Injury <br />g <br />b <br /> f^ Prem~ses;Operahons <br />P <br />D <br />500, 000 <br />500, 000 <br /> Ley ProductslCompleted Operations roperty <br />amage g $ <br /> L <br />I II~~ <br />LJ Contractual Botlil In y <br />Y lur 6 <br /> T ^ Other Ispecily below) Property Damage $ 500,000 g500~000 <br /> Y <br />^ Metl. Pay. $ ver $ Per <br />COmbinetl <br /> Persan acooenr <br />^ Personal Injury <br />^ A ^ 8 ^ C PefSpna l In ur <br />I Y <br />$ <br /> Limits of Liability <br /> A <br />U ~~I <br />^ Lmbihty ^ Nomowned ^ Hired <br />- Bodily Injury (Each Person) $ <br /> T r <br />L ~ Comprenensrve~Depuctible $ Bodily Injury (Each Accitlentl $ F <br /> O <br /> <br />M _I Coltrswn-Deductible $ <br /> <br />O <br />^ Medical Payments $ Property Damage $ <br />~ 8 <br /> l ^ Uninsured M1lotorist $ f <br /> L ^ No Fault Isoec~fyp Bodily Injury 8 Property Damage f <br /> <br />P c <br />~ , 7 <br />^ Other (SpeGty l' I <br />COmbined $ <br />^ WORKERS' COMPEN SA,TION -Statutory Limits (speufy Stales below! ^ EMPLGYERS~ LIABILITY -Limit $ <br />GUN UITION 510TH EH GOVEHAG ES <br />The Company agrees to notify the Mined Land Reclamation Division of the State <br />of Colorado of any significant changes in the policy including changes in the term of <br />failure to renew, <br />rva,AE oND /DORESS OE L, ~ mOPIU/.dEE ^ 1055 P/•+EE ^' applrlSUPE] <br />t` BiIPI1:LAiy'D R CLAL'.'.ATION <br />DIVISION Or COLORADO ~~<rr rmr,eE~ <br />DEtiVER. COLORADO ~ , <br />ATTN: SdIKE LOidG <br />nr_CRD ? I •. ~Ir~ n <br />. ...a:... ,~. - - .. c <br />,y~ ~ ,'M,' ~ , .~ <br />ELAINE FUt:ARQ. 6+iic:lv7 I <br />Inland Imurance Ag^n:;y { i <br />tg74 Main Ave. Suite 108 , <br />Durango,Cd;Bt 01 <br />Of Ic 24 ~- <br />Signature of 4ulnorueU F.eore sen:a~.rve GV ~ i <br />~~' ~,'l.r . _ i <br />
The URL can be used to link to this page
Your browser does not support the video tag.