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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 />1 <br /> <br /> <br />1 <br /> <br />f, <br /> <br /> <br /> <br /> <br />1 <br /> <br /> <br /> <br />This is to Certify That , <br />M~CGRIFF SEIBELS & WILLIAMS, INC. Certificate No. <br />nmc+s+w I1~TSURANCE ~~~ <br />~$,~ 2211 7th Avenue, South/Birmingham. Alabama 35233 MSB C 621 e <br />P.O. Box 10285/Birmingham, Alabama 35202-0285 <br />TEL-(205) 252-9871 TLX-5-9821 MACSEIB BHM <br />as broker for [he Named Insured, has procured the insurance coverage described below with thelnsurance Company shown on <br />Certificate. <br />I~ NAM[D INSURED AHD MAILING ADDRESS <br />TRAPPER MINE INC. <br />DArE: 12-3-82 <br />P.O. BOX 187 <br />CRAIG, COLORADO 81626 <br />L J <br />OR AHOUT <br />EFFECTIVE DATE Beginning at 12:01 A.M. on the_~day of JANUARY l9 $~ <br />and ending atPENDING RRCEIPT on the OP day of PO IR 19_ <br />Standard time at [he place of location of risks insured. <br />HOME INSURANCE COMPANY <br />AUTOMOBILE LIABILITY $500,000 COMBINED SINGLE LIMIT <br />TERMS AND CONDITIONS AS PER ATTACHED <br />PER: ROB BILLINGS <br />Acting upon instructions Crom the Insured, and in consideration of [he 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 Corms in use by Ute <br />Insurance Company as o[ the effective date of this Certificate and is subject [o all terms and conditions of said contract. <br />~]~; CF:TFI/F:f .C & WII,LJAMS, INC. I <br />gy ~~l~r-~~f/ G2 ~~*~fG~i/J <br />,. <br />'fi'r-~ - 't- -`' ~ ~ ,~. <br />r;1-e <br />
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