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GENERAL32806
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Entry Properties
Last modified
8/24/2016 7:55:08 PM
Creation date
11/23/2007 7:26:29 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981029
IBM Index Class Name
General Documents
Doc Date
12/9/1985
Doc Name
CERTIFICATE OF INSURANCE
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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<br />I <br />N <br />n <br />I <br />i <br /> ~ <br />~ J~ 0 r <br />~ ~y <br />r <br />~~VJ <br />I <br />`7~~ ~II ~I~~I~~I~~~~~~I~ S <br />D <br />~I ~ _ <br />` <br />~ <br />` 12- <br />1 <br />-851 m <br />PRODUCER 7X18 CERTIFlCA7E 9 ISSUED AS A NW TTER OF INFOAC7ATN~ ONLY AND CONFERS <br /> NO RIGHTS UPON TXE CERTIFlCATE HOLDER. THIS CERTIFlCATE DOES NOT AMEND, <br /> EMEND OA ALTER THE COtlERAGE AFFORDED BY THE POLICES BEL04Y. <br />Flat Top Insurance Agency COP7PAR11ES fAIFIFOPJDE~U(a CObER~Gf~ <br />P. 0. BOX 1434 COMPANY Q <br />Bluefield, WV 24701 0 <br />~~ OTTER Old Be ublic Insurance Compan <br />~~ ~ <br /> r~ <br />'"- <br />';" :T7SURfdA1CE ~ <br />GEMCY ~- <br /> p , <br />, <br />. <br />INSURED :, D.:. ~• "_' ]Oa]ZLUII <br />$Un Coal Company, Inc. <br />~~~ COMPANY <br />6 ~-=-.l::E•Y]L~I VI>rlnL^2.TBt <br />P. 0. BOX 26 <br />9 ER <br />Milner, CO 80477 ~RNV Do ~IIY <br />~E~~~ <br />~ <br />j <br />p <br />, <br />~~ L <br />I <br />A <br />7r <br />r <br />~ 1~ ,V~yA <br />1~~{n"~~1"1,,~s~~~ <br />~A. N <br />~~ ALL FOR7130'r IKSURAt.CE <br />%'I <br />9 <br />~ <br />; <br />V <br />H <br />P/ <br />D <br />' <br />~ <br />• -, <br />••~Wr4:i ~ ~ ei,vi b. v. <br />: <br />: ~,, <br />n• <br />. <br />CA^ <br />rnn?Y. <br />Cxlon, <br />. Y: <br />. <br /> ip _ <br />~,~Ax~~~ <br />THIS IS 70 CERTIFY THAT POLICES OFINSURANCE LISTED BELOW HAVE BEEN ISSUED70 THE INSURED NAMED ABOtlE FOR THE POLICY PERIODINDICATED. <br />NOTWRXSTANDING ANY REOUIREF.~ENT, TER~9 OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO tiIF41CX THIS CERTIFlCATE F.TAY <br />BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 5 SUBJECT TO ALl THE TER:.7S, EXCLUSIONS, AND CONDI- <br />TIONS OF SUCH POLICIES. <br />CO PoDLV FREC7NE POLICY ElwlluP0.v LIABILITY LIMITS IN THOUSANDS <br />LTR TYPE OF INSURANCE POLICY NUM BER Dph IMMRD.M1) DA1F MM'DA%Vl EACH <br />OCCURRE AOGAEGATE <br /> G ENERAL LIABILffY BOOav <br />Iwugr <br />~ <br />$ <br />A x COMPREHENSNEFORM ZC46493 2-6-85 3-1-87 1,000, 1,000, <br /> R PREMISES/OPERATIONS pgppEg7y <br />$ <br />$ <br /> X U <br />X~O6 <br />C <br />NU DAMAGE 1 <br />000 1 <br />OOO <br /> 10 <br />F <br />OLLAPSE HAZARD <br />d , <br />, , <br />, <br /> X PRODUCT&COMPLETED OPERATIONS <br /> <br />R <br />CONTRACTUAL BI a po <br />COMBINED <br />$ <br /> X INDEPENDENT COHTRAC70F5 <br /> X BROAD FORM PROPERTY DAMAGE <br /> X PERSONAL INJURY PERSONAL INJURY <br /> A UTOMOBILE LIABILITY WWY <br />A x ANY AUTO TB9246 2-6-85 3-1-87 ~a <br /> 7L ALL OWNED AUTOS (PRIN. PASS.) Bm1r <br /> <br />X OTHER THAN <br />All OWNED AUTOS ~PRN PASS ~ N].av <br />(PEAN~lR <br /> X HIRED AUTOS pgppERn <br />DAANOE <br /> X NON-0WNED AUi05 <br /> GARAGE LIABILffV el 6 PD <br />COM <br />D o. <br /> BINE W 1 D00 ~ <br /> EXCESS LJABILlTY <br /> UMBRELLA FORM BI 6 PD <br />COMBINED <br />gi i <br />y <br /> OTHER THAN UMBRELLA FORM <br /> WORKERS' COMPENSATION STAMORr <br /> AND $ (EACH ACCIOENn <br /> ' (DISEASE-POLICY LIMIp <br /> EMPLOYERS <br />LIABILITY (DISEASE-EACH EMPLOYEE) <br /> OTHER <br /> Environmental <br /> Impairment ZP0241 2-6-85 3-1-87 1,000,000 <br />DESCRIPTION OF OPERA710NS~LOCA710NSNEHN;LES/SPECIAL ITEMS <br />Capstan Mining Company -Bacon Mine Sun Coal Company -Meadows 111 Mine and <br />Meneffe Land Company - Shalako Mine Trout Creek 112 Mine <br />iH6~\~ Ir". o o (~''Y~Q~41~V. o ~I <br />Colorado Mine Land Reclamation Board SXOULD ANY OF THE ABOVE DESCRIBED POLICIES aE CANCELLED BEFORE THE E7f- <br />PIRATION DA7E THEREOF, 7HE ISSUING COMPANY WILL ENDEAtlOR TO <br />1313 Sherman Street MNL~O_OAYS l'JRII'TEN NOTICE 70 THE CERTIFICATE HOLDER NA.^.:ED 70 TT:E <br />Denver CO 80203 LEFT, BI]r FAILURE TO rvuL sLFCEI NOTICE SHALL r.:vosE NO oBUGAnoal Da LIA9.'LIIY <br />+, OF ANY HIND UPON THE CO::PANY, ff5 AGENTS QR_ REpgES)=NTA7O!£S. <br />=1:7 <br />I~ <br />~I i <br />• ~ fl~ <br />
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