Laserfiche WebLink
10-10-1003 05:08PM FROIN-RUtnam a¢ertcy <br />606325TT67 T-666 P 004/005 F-163 <br />ACORD, CERTIFICATE OF LIABILITY INSURANCE csR~TK "^""°'"w"""' <br />LORffit-1 10 .3 03 <br />PRODUCER <br /> <br />Putnam Agency, xnc . <br />P. O. Box 991 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIC N <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OE <br />ALTER7HE COVERAGE AFFORDED FSY THE POLICIE588L0 N. <br />Ashland RY 0.1105 <br />Phone: 606-329-2200 Pax: 606-325-7787 <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />INSURED INSURER A: Federal Ine • CO. <br /> INSURER 9; <br />Lvaencito Coal Company, LLC INSURERq _ <br /> <br />3800 COUntY SiQ8263,0 <br />d CO <br />i <br />id <br />IRSURERD; <br />- _ <br /> <br />- <br />Tr <br />a <br />a - <br />INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW NAVE BEEN ISSUED 70 THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NONJRH$'fANOING <br />ANY REQUIREMENT, TERM OR CONORION OF ANY CONITLICT OR OTHER DOCUMENT W Rli RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BV THE POLK:IES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND GONDfiIONS OF SUCH <br />POLd:IES. AGGREGATE LIMR5 SHOWN MAY HAVE BEEN REOtJCED SY PAiO CLAMS. <br />J- <br />LTR NS TYP OF WSURANCE POLICY NUMBER D47E MMID DAp LIINITS <br /> GENERAL LUUOLITY PALM OCCURRENCE S 10 O 100 0 <br />A K X COMMERCIAL GENERALLIABILRV 3711-11-13 lO/10/03 10/10/04 PREMISES EBOaurmnel 51001 00 <br /> CLAIMS MADE ~ OCCUR MED FJIP (My me perm) 5 SO D' i O <br /> PERSONALaADV INJURY 4100 IOOO <br /> GENERAL AGGREGATE 5200 1000 <br /> GEN'L AGGREDATE LIMIT APPLIES PER: PRODUCTS • COMP/OP AGG S 10 0 1 O O O <br /> POLICY jam( LOC ~~ <br /> avT OMDBLLE LNBILRY <br />COMBINED SINGLE LIMB <br />S <br /> ANY AUTD (ES Bmdmlj <br />-- <br /> ALL OWNED AUTOS BODILY IWUftY - <br />S <br /> 3CHEDUIEDAUT08 (Per perspn) <br /> HIREDAIROS <br />BODILY INJURY <br />9 <br /> NONOWNRD AUTOS (PeY eLLidenl) <br /> PROPERTY DAMAGE <br /> <br />P S <br /> ( <br />er acalemq <br /> GARAGE LWBILTTY AUTO ONLY. PA ACCIDENT S <br />-- <br /> ANY AUTO OTHBR THAN FA ACC 9 <br />- <br /> AUTOONLY: AGG E <br /> F]ICESSNMBRELIA LUVOLRY BACH OCCURRFIJCE a <br /> OCCUR ~ CLAIMS MADE AGGREGATE S <br /> S <br /> OFJ]UCTIBLE S _ <br /> RETENTION S , 5 <br /> WORKERS COMPENSATION ANO RV IMR ER <br /> EMPLOYERS uaBUm <br />ANY PROPRIETORIPARTNERrEJ~CUTIVE <br />EL FACHACCa1ENT I§ <br /> <br />OFFICERIMEMBER EXCLUDED? _^_ <br />E.L. OISEASE•EA EMPLOY S _ <br />^_ <br /> If yyea, dP:o16e wMw <br />SPECIAL PROVISIONS below <br />E.L. OISEASE•POLK:Y LIMR~ <br /> OTHBR <br />DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLE9l OLCLU910N8 ADDED BY ENDORSELIETIT I SPECULL PROVISIONS <br />Permit #C-81012, 3 1/2 miles 1Q/N' Weston, Colorado, Township 33, South, Range <br />68 West. <br />COLOR-2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIE38E CANCELLE08EF01 ETNE EXPIRATION <br />OATS THEREOF, THE ISSUING INSURER WILLY~1fIBE7LVTOi]CdIMAR 3O DAYS WRITTEN <br />Colorado Division of Miaeials NOTICE TO 7HEC TO NOLOPR NAMED TO THE LEFT, BiYD~OR RR~471WX <br />and Geology ( ga ca30t] sAaEAX~B <br />1313 Sherman Street, RotrtB 215 <br />Deaver CO 80203 <br />'ORATION 198E <br />