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GENERAL30345
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Last modified
8/24/2016 7:47:55 PM
Creation date
11/22/2007 10:12:04 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981034
IBM Index Class Name
General Documents
Doc Date
5/31/1990
Doc Name
CERTIFICATE OF INSURANCE
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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~ \ ~ v ~"- <br />acl-~.i-. ~ CERTlFlC_ATE O_ F_ 1NSURAN~~,:~~~+AX~_~y]Lygj..'~ 5 z4 0~l <br />PiN)DULfR ~~v._ •' ~ II I~ I II I II I II (III III TEXTENDHOR ALOTER T~HE~CE.O~VE~RAGE AFFORDED B~Y THE POLE ESLBELOW OT AMEND. <br />The Linden Company 999 _ _ <br />P.O. Box 60130 <br />Grand Junction, CO 81506 COMPANIES AFFORDING COVERAGE <br />CODE <br />SU&CODE <br />SEM Construction Company <br />773 Valley Court <br />Gzand Junction, CO 81505 <br />coMPANr <br />LETTER A Employers Mutual Company <br />COMPANY B <br />LETTER <br />COMPANY <br />LETTER C <br />COMPANY D <br />LETTER <br />COMPANY E <br />LETTER <br />+V THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUPED NAMED ABOVE FOR THE POLICY PERf00 <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 MAV PERTAIN. THE INSURANCE AFFORDED RV 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 />'O TYPE OF INSURANCE DOLICY NUYBER DOLICY EFFECTIVE POLICY EIPIRATIOM ALL LIYITS IM THOUSANDS <br />fR DATE IMMIDOIYYI DATE IMMIDDM') <br />GENERAL DABILITI' <br />A X COMMERCIAL GENERAL LIPBILITY 9D90866 5-10-90 5-10-91 <br />CLAIMS MADE X OCCUR. <br />OWNER'S 8 CONTRACTOR'S PROT. <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />A x 9E90868 <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />x HIRED AUTOS <br />X NON-0WNED AUTOS <br />GARAGE LIABILT' <br />_ _ EXCESS LIABILTTY -.'- __ _._-, __ __- - - ___ <br />OTHER THAN UMBRELU FORM <br />WORKER'S COMPENSATION <br />AND <br />EMPLOYERS' LIABILR\' <br />OTHER <br />)ESCRIPTIOM OF OPERATIONS/LOCATONSNEMICLES/RESTRICTION55PECIAL REY$ / <br />4inrec, Inc, is named as an "Additional Insured". ~ `~ <br />2E: Mining Permits - C-81-025, C-81-047, and C-81-034 <br />GENERAL AGGREGATE S 2 , OOO <br />PRODUCTSLOMPIOPS AGGREGATE S 2 , OOO <br />PERSONAL S ADVERTISING INJURY S 1, OOO <br />EACH OCCURRENCE S 1, OOO <br />FIRE DAMAGE IMy ons lee) S SO <br />MEDICAL EXPENSE IMy one person) S 5 <br />COMBINED <br />SINGLE S <br />LIMIT _ 1, OOO . _ _ <br />BooaY <br />INJURY S <br />(Per person) <br />BODILY <br />INJURY S <br />(Per a¢ieenl) <br />PROPERTY S <br />DAMAGE <br />EACH AGG REGATE <br />OCCURRENCE <br />S S <br />STATUTORY <br />5 <br />E <br />S ___ <br />IEALH ACLIOENi) <br />(DISEASE-POLICY OMff) <br />(DISEASE-EACH EMPLOYEE) <br />Land Reclamation Division <br />Sherman, Room 215 <br />r, CO 80203 <br />ACORD 25-S <br />0.HCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />E%PIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO <br />MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE <br />LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR <br />LIABILT' OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES. <br />ITATVE r <br />`/ l <br />`J t BACORD CORPORATION 1968 <br />
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