My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
GENERAL31141
DRMS
>
Back File Migration
>
General Documents
>
GENERAL31141
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
8/24/2016 7:48:30 PM
Creation date
11/23/2007 6:53:16 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981039
IBM Index Class Name
General Documents
Doc Date
4/8/1981
Doc Name
CERTIFICATE OF INSURANCE
Permit Index Doc Type
INSURANCE
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.
/
3
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
~~•~ . ~~ <br />°a° ®IIIIIIIIIIIIIIIIIII ~~~-~ <br />Medalist•Kline Agency, mc. 999 <br />CERTIFICATE OF INSURANCE <br />Date April 6, 1981 <br />This is to certify that the following policies have been issued [o: <br />Name E Address of Insured The Rockcastle Company & Rvan Incorporated of Wisconsin, <br />_ _ P. O. Box 2~ Janesville, WI 53545 ~~~ (~[~A~DFr~,,; <br />Project Permit for Grassy Creek Coal Min in <br />Rou tt County, Colorado AQ8 - $ 1981 <br />ft91A+ED LAND RECUI,AF~TID;g <br />WORKER'S COMPENSATION: CCnn n ~ <br />Policy No. wC 1 011 027 Inception Date 4-1-81 Expiration-D'Pte'e`~LPAe~I'!ura1R^a~,..,.~.,, <br />Insuring Company Bituminous Fire & Marine Insurance Co an <br />Coverage: Worker's Compensation - Statutory Employers Liability Limit: 100,000 <br />Locations Covered All States Endorsement Attached To Policy <br />COMPREHENSIVE GENERAL LIABILITY: <br />Policy No. GL 1 183"610 Inception Date 4-1-81 Expiration Date 9-1-82 <br />Insurance Company Bituminous Casualty Corporation <br />Limits of Liability: <br />Bodily Injury Liability $ 500,000 Each Occurrence Combined <br /> $ 500,000 Aggregate OR Single <br />Property Damage Liability $ 100,000 Each Occurrence Limit $ <br />$ 100 000 Aggregate <br />Coverage Provided (Check Applicable Blank <br />Premises Operations <br />Elevators, If Any <br />Completed Operations/Products <br />Blanket Contractual Liability to include coverage for "Hold Harmless <br />Agreement" if such agreement is contained in the specifications <br />of subcontract, subject to policy terms <br />Personal Injury, Employee Exclusion Deleted <br />Independent Contractors <br />Employees as Named Insureds <br />Broad Form Property Damage, Including Completed Operations <br />Property Damage Liability covers: <br />Damage due to blasting <br />Damage due to collapse <br />Damage to underground facilities <br />Special Liability Supplement Endorsement Included <br />Yes No <br />x _ <br />x _ <br />x <br />x <br />x <br />x <br />x <br />x <br />x <br />x <br />x <br />x <br />COMPREHENSIVE AUTOMOBILE LIABILITY: <br />Policy No. BA 1 321 006 Inception Date 4-1-81 Expiration Date 4-1-82 <br />Insurance Company Bituminous Casualty Corporation <br />Limit of Liability: <br />Bodily Injury Liability $ Each Person Combined <br />$ Each Occurrence OR Single <br />Property Damage Liability $ .Each Occurrence Limit $ 500,000 <br />Yes No <br />Coverage is provided for operation of all - Owned Vehicles x <br />Non-Owned Vehicles x <br />Hired Vehicles x <br />
The URL can be used to link to this page
Your browser does not support the video tag.