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GENERAL31141
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GENERAL31141
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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
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-... <br />. •-~. <br />UMBRELLA LIABILITY: <br />Policy No. Inception Date Expiration Date <br />Insuring Company <br />Single Limit Liability: $ Retention: $ <br />OWNER'S PROTECTIVE OR RAILROAD PROTECTIVE LIABILITY: <br />Policy No. Inception Date Expiration Date <br />Insuring Company <br />Name E Address of Insured <br />Limits of Liability: <br />Bodily Injury Liability <br />Property Damage Liability <br />SPECIAL COVERAGE:_ <br />Policy No. <br />Insuring Company <br />Name E Address of Ins <br />$ Each Occurrence Combined <br />$ Each Occurrence OR Single <br />$ Aggregate Limit <br />nception <br />ration Date <br />Amount Deductible <br />MORTGAGE CLAUSE: <br />Loss, if any, to be adjusted only with the insured named herein and payable to the insured 6 <br />as their respective interests may appear, subJect, nevertheless, to all the terms and condi- <br />tions of the policy and the Standard Mortgage Clause, U. F. Form No. 127 B (9-34) <br />CANCELLATION; Should any of the above described policies be canceled before the expiration date <br />thereof, the issuing company will mail 30 days written notice to the below named certificate <br />holder, but failure to mail such notice shall impose no obligation or liability of any kind <br />upon the Company. Colorado Department of Natural Resources <br />Mined Land Reclamation Division <br />1313 Sherman St. _ <br />Denver, CO 80203 _ - <br />This certificate is issued as a matter of information only and confers no righfs-upon=then= <br />certificate holder. This certificate does not amend, extend or alter the coverage afforded <br />by the policies listed above. <br />x Bituminous Casualty Corporation St. Paul Fire 6 Marine Insurance Company <br />x Bituminous Fire E Marine Insurance Lo. United States Fire Insurance Company <br />General Casualty Company of Wisconsin United States Fidelity b Guaranty Company <br />Regent Insurance Company Fidelity 8 Guaranty Insurance Underwriters, Ins <br />Maryland Casualty Company -Haw~~ye~curity Insurance Co. <br />Countersigned By: l.L'/!'CiG <br />of E for Me ist-K ine Agency, Inc. <br />P. 0. Box <br />Middleton isconsin 53562 <br />Authorized Representative <br />
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