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GENERAL33553
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GENERAL33553
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Entry Properties
Last modified
8/24/2016 7:55:28 PM
Creation date
11/23/2007 7:40:37 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981010
IBM Index Class Name
General Documents
Doc Date
3/21/1983
Doc Name
PROPOSAL OF INSURANCE
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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c <br />'~ <br /> <br />1 <br /> <br /> <br />1 <br />1 <br />1 <br /> <br />1 <br />1 <br /> <br /> <br /> <br />1 <br />1 <br /> <br />~~C~ ~ -~y a9~°, <br />~,~ 'o <br /> a <br />1 This is to Certify That <br />~ Certificate No. 1 <br />It1~c+s+w MCGRIFF SEIBELS & WILLILIMS, INC. ~ <br />I1V5[JRAIVOE RR~j{L.SLa <br />2211 7th Avenue, South/Birmingham, Alabama 35233 MSB C 617 <br />P.O. Box 10285/Birmingham, Alabama 35202-0265 <br />TEL-(205) 252-9871 TLX-5-9821 MACSEIB BHM <br />as broker for the Named Insured, hat procured the insurance coverage described below with thelnsurance Company shown on [his <br />Certificate. <br />NAMED IN gU REp AND MAILING ADDREgg <br />TRAPPER MINE INC. <br />D <br />r <br />12-3-82 <br />A <br />E: <br />P.O. BOX 187 <br />CRAIG, COLORADO 81626 <br />L <br />12:01 A.M. OR ABOUT6TH JANUARY 3 <br />EFFECTIVE DATE Beginning at on the day of 19g <br />and ending at PENDING RECEIPT on theOF POLIC~gy of 19_ <br />Standard time at the place of location of risks insured. <br />INSURANCE COMPANY OF NORTH AMERICA <br />AIR CRAFT NON-OWNERSHIP LIABILITY <br />TERMS AND CONDITIONS AS PER ATTACHED <br />PER: KEITH ANDERSON <br />~m <br />Acting upon instructions [rom the Insured, and in consideration of the payment of the premium shown above, which is an esti- <br />mated premium, this Certificate has been issued to evidence the insurance coverage procured until this Certificate is cancelled <br />by written notice to the insured or is replaced and thereby terminated, by the formal contract of insurance to be issued by the <br />Insurance Company. Coverage evidenced by this Certificate is in accordance with the standard policy and forms in use by the <br />Insurance Company as of the effective date of this Certificate and is suhject to all terms and conditions o[ said contract. <br />McGRIFF: ~`fRF'[ s & WII~LIAM.S, INC. <br />,,// ` ~ ~ ~ J~ <br />~ $y ~ICIGC. ti ~ , <br />f~ 9 <br /> <br />
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