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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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<br />~~ This is to Certify That I <br />' ~It McGRIFF SEIBELS & WILLIAMS. INC. Certificate No. <br />McG+S+W ~ <br />I1N5[JRAN~ ~ MSB C 630 <br />' t,.~ ~,' 2211 7th Avenue, South/Birmingham, Alabama 35233 <br />P.O. Box 10285/Birmingham, Alabama 35202-0265 <br />TEL-(205) 252-9871 7LX-5-9621 MACSEIB BHM <br />as broker for the Named Insured, haz procured the insurance coverage described below with the Insurance Company shown on [his <br />Certificate. <br />NAMED INSURED AND MAILING ADO RESS <br />' TRAPPER MINE INC. 12-3-82 <br />DArE: <br />P.O. BOX 187 <br />CRAIG, COLORADO 81626 <br />L J <br />12:01 p.M. OR ABOUT <br />EFFECTIVE DATE: Beginning at on the 6TH day of JANUARY I9~ <br />and ending at PENDING RECEIPT on the OF day of POLICY 19_ <br />Standard time at the place of location of risks insured. <br />1 <br />' HOME INSURANCE COMPANY <br />ALL RISKS OF PHYSICAL LOSS OR DAMAGE <br />t <br />t <br />t PER: ROB BILLINGS <br />a.., <br />Acting upon instructions Crom the Insured, and in consideration oC 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 Lerm inated, by the formal contract of insurance to be issued by the <br />Insurance Company. Coverage evidenced by [his 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 subject to all terms and conditions of said contract. <br />~ t l~,rp("~'j~~RF.TTiF!i.C gi 4VfT.i.7AM$~jjv(~, <br />l; y <br /> <br />
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