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GENERAL31528
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GENERAL31528
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Entry Properties
Last modified
8/24/2016 7:54:37 PM
Creation date
11/23/2007 7:01:42 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981014
IBM Index Class Name
General Documents
Doc Date
3/10/2006
Doc Name
Certificate of Liability Insurance
Permit Index Doc Type
Insurance
Media Type
D
Archive
No
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~~~®~~'~ <br />If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement <br />on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may <br />require an endorsement. A statement on this certificate does not confer rights to the certificate <br />holder in lieu of such endorsement(s). <br />The Certificate of Insurance on the reverse side of this form does not constitute a contract between <br />the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it <br />affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. <br />~~ F ~~^~= INSURED'S NAME Energy Fuefis Corporation <br />ENERG-,l PAGE 3 <br />OP ID S4 DATE 03'f 08/06 <br />Reference: Kerr Mine Permit #C-80-006 and Southfield Mine Permit <br />#c-81-014.3 <br />
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