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GENERAL30273
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Entry Properties
Last modified
8/24/2016 7:47:52 PM
Creation date
11/22/2007 10:10:52 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981044
IBM Index Class Name
General Documents
Doc Date
9/7/1994
Doc Name
Certificate of Insurance
From
ENERGY INSURANCE INTERNATIONAL INC
To
DMG
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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(~Qr#i~itA#.~ a~ ~nsusrznr.~ <br />To: Division of Minerals & Geology o•t•: Sepoember 7, 1994 <br />Ada.e..: Department of Natural Resources Re: Soe Atffichment <br />1313 ShealOan SL, Room 216 <br />Denver, CO 80203 <br />Thh h to certdy That the pollcla, de,lgna[ed below ere in force on the tls[e born. by thi^ Cart ificRS. <br />NAME OF INSURED: Cyprtl! Amax Mlntxals Company d al including Subsidiary Companies <br />9100 paaF Mineral Cite <br />Ader..,: Frtlglewt7(7d, CO 80112 <br />o. itiauw.wce <br />roucr r roux renioo rouov <br />A) Commm~elal Caenesal Llabiltry - 04/01/94 - (6,000,000 Oemete] Aggregate <br />Incltrdlag PromleWmdor and 04/01/93 56,000,000 Product/Com~lemd Opetatlone <br />XCU Cavmsga, CLfmr Made, OL3197123 Aggregate <br />Re4o Date: 7/1/86 OL3197127 52.000.000 l4taonal and Advertising In}nry <br />a) AU Staten f2,000,000 Eanb OoCOesmos <br />b) Teas 52,000,000 Fin Damage (Aqy One Pisa) <br />S 10,000 Medlal S:panne (Any One <br />Perstm) <br />H) Aura Liabl7iry 61fi1/94 - 52,000.000 CSL Sara Oopumnoe <br />a) All Steep CA1431a16 04/01/93 <br />b) Taxis CA1431a19 <br />c) wprlcets~ Compaoaarlon o9ro1/94 - wc: sntntory <br />Bmg7byan•. Leabiliry 09/01/93 BL: 52,000,000 Each Aoeideot <br />Cal[fotda Only 0016120-02 52.000,000 Dltleaae - Poliey Llmle <br /> (2.000.000 Dlaesse - E,lele Stnployp <br />D) Wosben' Cfxnpeaaattm 09/01/94 - WC: SOStrrtory <br />Smployera• Llablliry 09/OINS SL: 52,000,000 Hacb Aaeideat <br />Othx 9talea 001611602 (2,000,000 Dlaeeae - Poliey Llm1t <br /> 52,000,000 Dipeee - Ssoh Employee <br />~ Bxpaa Wodmn' Compeaaatloo •RX-113 09/01/94 _ CcmpagY L{mit of Indemnity Bach <br /> 09/01/93 Ooean'aese: SestoOOry <br /> Self Iaseted Retention: 51.000.000 <br />Thl, cer[I}la[e of In,urantt neither eHirme[Ivaly nor negetlvely emends, e+rtentls or alters the eoverege afforded by thole Polley lle,l <br />whleh numbered above end which luued by rnmpenles II,[etl below. <br />INSURANCE COMPANY(IEaI <br />18aVING COVERAGE: <br />A)B) National tJllioa Fire Ins. Co. <br />C)D)8) Old Republic *ua'*ance Company <br />e~lr <br />1-- <br />2000 aerina Dr., suite 91x1 <br />Hwemn. Te.e, 7'!057 <br />P.O. Boa 76429 <br />Romwn. bxu 77276-M29 <br />Phone: 717/7x7-6640 <br />Telex 791 397 <br />Ini 1. Tel<a 166 2a] or 166 28a <br />T<lecoPler 7t7ne3a2u <br />c i~•~ •T'T -7 TbPJ FGIfFL] W.-17b:~ bfi. LB d35 <br />
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