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GENERAL31342
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Entry Properties
Last modified
8/24/2016 7:54:32 PM
Creation date
11/23/2007 6:59:05 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1982056
IBM Index Class Name
General Documents
Doc Date
10/18/2005
Doc Name
Certificate of Insurance
From
Byron Walker
To
Jerry Nettelton
Permit Index Doc Type
Insurance
Media Type
D
Archive
No
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<br />ACORD„ CERTIFICATE OF LIABILITY INSURANCE Page i of 2 D9/3oi2DD5 <br />PROOUCmI 877-945-7378 THIS CERTIFICATE IS ISSUED AS A NATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHT9 UPON THE CERTIFICATE <br />xiliie aorta America, lac. - Regional cart center HOLDER. TH19 CERTIFICATE DOES NOT AMEND, EXTEND OR <br />2s century Elva. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />P. O. m: 105191 <br />aseMille, '[e 372]05191 INSURERSAFFORDING COVERAGE NAICf{ <br />MWAfa Peaeoay 8aargy corporation IN6WERA ACB American Iaauraaee CO 22667-001 <br />701 MnrAat Street <br />L <br />i <br />MD 63101 <br />1826 <br />IN9URERa <br />ov <br />St. <br />a, <br />- <br /> btSUREA C: <br /> INAABR O: <br /> 4uSURERE: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW NAVE BEEN ISSUED TO THE MSUR® NAMED ABOVE FOR THE POLICY OERIOD MOICATED. NOTWITHSTANDING <br />ANY REQUIREMEM'. TERM OR CONDRTON OF ANV CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE WlY BE ISSUED aR <br />MAY PERTAM, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREM t3 SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDRTONS OF SUCH <br />Pq,IC1E5. ACGFtEWTE UMRS SHOWN MAY HAVE BEEN REDUCED BY PAW CLAIMS. <br />PO eFFECaYE PeIJCY <br />L~ <br />R <br />IR TYPHOReaaNGMCH POIJCYMDMHER HR H <br />A oEN¢RASUAelurr BtDOG21713661 10/1/2005 10/1/2006 PACHOCgMRExCE s 00 0 0 <br /> COMMERCHt GEIVERALLMHHOY O IRED f D <br /> gAaai MADE ®OGGIIN MED EXP 1 s 5 <br /> PEREONALa ADV INJURY s 1 ODO 00 <br /> GENEAW.AGGREGATE s 000 Do <br /> GENIAOGREWTE UMrc APPDE8 PER: PROWCtS•COAmWPA00 f 4 D <br /> POLICY LOC <br />A Au roMOen.H LMapJiY ISAH08021892 20/1/2005 iD/1/2006 coMewEOSirKAEUwr <br /> X aNr AUm IEaecaeael S 2,000,000 <br /> ALL UYNEOAUlOE <br />IL <br />WURY <br />f <br /> SCHEOUIEDAUTOS ~ <br />~ <br /> NWED AUi05 <br />~Y <br />mA <br />laY <br />s <br /> NON-0WNEDAUt05 l <br />~ <br />e <br />l <br /> PROPERfYDAWGE <br /> <br />P f <br /> ( <br />rmdOeMl <br /> DARAGE LIAaWtt AUTOONLY•FAACCNEM S <br /> PNYAUTO OTNERTHAN FAACC f <br /> AUlOONLY: AGO f <br /> E%CEfa WBIUTY EaCHOCCURRENCE f <br /> OCCUR ~ CWMS WWE AGGREGATE S <br /> f <br /> DEDDGTIaLE f <br /> RETENDON f ~ i <br /> NONtFJiHDOMIEN9ATMIN AND <br />' STAIIA O <br />LIMIT <br /> ELPLOYERa <br />uAeAftt <br /> AHY PROPRIEIOWPARTNEWEXECUTNE EL FACNACCIDFM S <br /> OFFNN~RIMEMBERE%CLVDEDP E.LgSEASE-EAEMPLOYEE f <br /> pyey aavotewar <br /> HPEGIN. PRONSIgiSpMm~ EL gSFAHE-POLICYDMIT f <br /> OTXER <br />OEHLmP1gM OF OPEMiIOMalpCATN?Mf ryE11N].ELFJRLUagNS ADDHD 6Y EMDOReEMENTIHPEL W. PRONSIONS <br />Tweatymile Coal Company and 8TII 8mpire Corporation/BAD smpize Corp <br />Including Permits C-81-044 and..C~82-056 <br />The Insurer will aotiiy the Division o substantive changes in peliay, inciudiag or failure to <br />renew. <br />CERTIFlCA7E HOLDER CANCELLATION <br /> sxoma ANY ~ THE AeovE oeaeAmm PDUCm eH cANCauAD 9ETDRE THH E%PIRAT NRf <br /> a3TE TIaREDF. a6 mSImIG LV9UAER NM.L H7DVYm1OlKlsNl 3 D WTa YaaTTEM <br /> NODCE TO THE CERTIFlCATE MOLDEII NAMED TD THE LEFI~9QIAi' 1H~L <br />le <br />C <br />d <br />D <br />t <br />t N <br />t <br />l R <br />a <br />ra <br />o <br />eper <br />mea <br />a <br />ura <br />eoouroee <br />Diviaioa O! ffinerala and Geology <br />Room 215 <br />1313 Sbetmaa Street AU <br />iNoR <br />HEDRlPRFHHNfA <br />Denver, CO 8D2D3-2273 / <br />' <br />l~.~ <br />ACORD 25 (2001!06) Collf 1417311 Tp1:917397 Cart:6267016 ®ACORD CORPORATION 1988 <br />
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