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PERMFILE40316
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PERMFILE40316
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Entry Properties
Last modified
8/24/2016 10:43:17 PM
Creation date
11/20/2007 10:16:46 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981071
IBM Index Class Name
Permit File
Doc Date
12/11/2001
Section_Exhibit Name
RN APPLICATION FORMS & LETTERS
Media Type
D
Archive
No
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~;SIIE DATE <br />M <br />,M <br />,DDIYV) <br />a~:~:r.~:.. CERTIFICA c OF INSURANCE J <br /> <br />PnooueER ~ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND <br /> CONFERS NO RIGHTS UPON THE CERTIFICATE Ito! DER. THIS CERTIFICATE <br /> DOES N07 AMEND, EXTEND OR ALTER THE COVEAA aE A'rFJRDED BY THE <br />SEnGWICY, JAMES OF TN, INC. POLICIES BELOW. <br />P. O. FOX 19910 COMPANIES AFFORDING CC'dF..P,AGE <br />KNOXVILLE. TN 37939 <br />(E,:S)~E4-912( COMPANY CLD ?cAa_IgLIC IN5LIRAN~= CC. <br />A <br /> LETTER <br /> COMPANY B T <br />INSURED LETTER <br />CYURUS PINE RALS CO. COMPANY (,• <br />C <br />AND TTY SLIE'SIDIARV CO. LErrER <br />P. O. ECX .v ~'~'3 COMPANY ~~: <br />D <br />Eh~GLc4JgOD, C0 901 JJ LETTER <br /> COMPANY E E,: <br /> LETTER <br />COVERAGES _ _ _ , <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 ANV REQUIREMENT. TERM OR CONpITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT 70 WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSU RANCE 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 />CO TYp! OF INSURANCE POLICY HUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS <br />LTR DATE (MMIOO/YY) DATE (MM/DOIYY) <br />GENERAL LIABILITY GENERAL AGGREGATE f <br />' COMMERCIAL GENERAL LIABILITY PRODUCTS-0OMPIOP AGO. f <br />I CLAIMS MADE OCCUR. PERSONAL 3 ADV. INJURY f 0 <br />OWNER'S 8 CONTRACTOR'S PROT. / / / / EACH OCCURRENCE f <br /> <br />_. _ _ _ _ FIRE DAMAGE !My on. Iln) 3 <br />_-.__.. <br /> MED. EkPENSE lAm/Orb p,.'fMl f <br />AUTOYOSILE LIASILITY <br />_ _ ' <br />COMBINED SINGLE ~ 3 <br />.___ ANY AUTO LIMIT__- _-- __-_-__QI <br />AIL OWNED AUTOS <br />~~ ~ _ BODILY INJURY ' <br />f <br />SCHEDULED AUTOS / / / / (P,r pa,On) <br />0 <br />_-_--~--- <br />HIRED AUTOS <br />_ BODILY INJURY f <br />NON-0W NED AUTOS IP,r leCIE.nO 0 <br />GARAGE LIABIGTY ' <br />- _ PROPERTY DAMAGE f ' 0 <br />EXCESS LIABILITY EACH OCCURRENCE 3 0 <br />UMBRELLA FORM / / / / AGGREGATE 3 0 <br />' OTHER THAN UMBRELLA FORM ~ ~- <br /> <br />WORKER'S COMPENSATION STATUTORY l~M1T9 _ <br />_ ..._._ <br /> EACH ACCIDENT 31, <br />000E000 <br />AMD <br />Ai 0000404604 <br />' _ <br />07/01/91 07/01/92 DISEASE=POLICY LIMIT ~{1, 00a 000 <br />~ <br />EMPLOYERS <br />LIASILITY DISEASE-EACH EMPLOYEE i <br />OTHER <br />i <br />AI EXCESS W. C. (1) ~ EX266 07/01/91 07/01/92' STATUTORY <br />DESCRIPTION OF OPERATIONSILOCATIONUVEHICLES13pECIAL ITEMS <br />(1) EXCESS W.C. APPLIES TO THE FOLLOWING:CO,KY,PA,UT,gL,AZ,GA,ID,MT,MO,NM <br />VT, NV, WV TWENTYMILE CORL CO., FOIDEL CREE~(MINE.PERMIT #C-82-056, COLORADU ' <br />YAMPA COAL CO.. MINE #~ PERMIT #C-84-062. MINES lh2 & ECKMAN PARK NC-81-071' <br />CERTIFICATE HOLDEA. . CANCELLA710N <br />'.. <br />. <br />' <br />~ ~ <br />~~ <br />• <br />: <br />. , <br />. <br />, <br />, <br />;e <br />.. ~:.. <br />., ?-...r <br />...i:..: .::_v_....,:h.` . <br /> SHOULD ANV OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO <br />STATE OF COLORADO MAIL JIII DAYS WRITTEN NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE <br />MINE LAM1ID RECLAMATION DEPT. LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOS O OBLIGATION OR <br />1313 SHFRMAN STREET, SUITE c 1 °~ LIABILITY OF ANYR/RD UPON THE COMPANY, ITS AGENT R R PREBENTATIVES. <br />DENVEF, CO 90^c03 `~ <br />, <br /> AUTNORIX' RnRESLM ~TIV= <br />/~ <br />~ ~ /' <br />~±~ <br /> _ <br />ACORD 25•S (7/90) ~ ~ ~ ~ ~ mACORO CORPORATION 19Y0 <br /> <br /> <br /> <br />
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