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GENERAL34421
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GENERAL34421
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Entry Properties
Last modified
8/24/2016 7:55:54 PM
Creation date
11/23/2007 7:56:29 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981022
IBM Index Class Name
General Documents
Doc Date
3/7/2000
Doc Name
CERTIFICATE OF LIABILITY INSURANCE
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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<br />acoRV CERTIFIGATf 4E <br />LIAB .:...:. <br />IL'ITY''' INSURANCE III ~~~~~~~~~~~~~~ <br />II <br /> <br />~cnomuDER~~~~~~ ~ ~ ~ ~ = <br />THIS CERTIFICATE IS ISSUED AS A I ggg <br />4 <br /> ONLY AND CONFERS NO RIGHTS UPON IttG t: t:nllrlL.A IE <br />MARYLAND HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />YCGRIFF, SEIBELG ANO WILLIAYG ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />10320 LITTLE PATUXENT STE 700 COMPANIES AFFORDING COVERAGE <br />COLUMBIA YD 210M <br />ED COMPANY <br />14101 884-5800 RECEN A OLO REPUBLIC INSURANCE CO <br />INSURED COMPANY <br />Dsl,em Yining. Ina. MAR 07 2000 e <br />1601 Forum Plec• COMPANv <br />Wss} Pslm, FL 33401 <br />alsBGeD~D9Y C <br />prv~wnofMiner <br /> COMPANY <br /> D <br />v.... <br />............................................................................... <br />................................................................................................ . <br />THIS ISTOCERTIFY THAT THEPOLICIES OFINSURANCE LISTED BELOW HAVE BEENISSUED 707HEINSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED,NOTWITHSTANDINGANV REQUIREMENT,TERMOR CONDITIONOFANVCONTRACTOROTHERDOCUMEN7 WITHRESPECT TO WHICHTHIS <br />CERTIFICATE MAV BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />E%CLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAV HAVE BEEN REDUCED BY PAID CLAIMS. <br />CO VGLIC~FFFCTIYE POLICY EAPIR11TI0 ~ <br /> TYPE OFINSURANCE POLICY NUMBER LIMITS <br />LTR DATE (MMIDDIYYI DATE IMMIDDIYY) <br /> GE NERAL LIABD_ITY GENERAL AGGREGATE $ <br /> COMMERCIAL GENERAL LIABILITY PRODUCTS~COMP/OP AGG S <br /> CLAIMS MADE ~ OCCUR PERSONAL 6 ADV INJURY S <br /> OWNER'S 6 CONTRACTOR'S PROs EACH OCCURRENCE S <br /> FIRE DAMAGE (Any one lire) f <br /> MED E%P (Any one person) f <br /> AUT OMOBILE LIABILITY <br /> COMBINED SINGLE LIMIT f <br /> ANY AUTO <br /> AlL OWNED AUTOS BODILY INJURY <br /> (Per person) S <br /> SCHEDULED AUTOS <br /> HIRED AUTOS BODILY INJURY <br />S <br /> NON~OWNED AUTOS (Per accitlenU <br /> PROPERTY DAMAGE g <br /> <br /> GARAGE LIABILRY AUTO ONLY - EA ACCIDENT S <br /> ANY AUTO OTHER THAN AUTO ONLY: <br /> EACH ACCIDENT S <br /> AGGREGATE f <br /> E%CESB LIABD.ITY EACH OCCURRENCE f <br /> UMBRELLA FORM AGGREGATE S <br /> OTHER THAN UMBRELLA FORM S <br />A WORKERS COMP.EtleATIONJ•!ID_ <br />' 08[01707302_ __ _ _ 1/01/00__ _7/01/01- %_ WC STATU- 0TH- <br />TORY IMIiS R' __ <br />-- <br /> EMPLOYERB <br />LIABILITY EL EACH ACCIDENT 4 1,000,000 <br /> THE PROPRIETOR/ <br />PARTNERS/EXECUTIVE INCL EL DISEASE~POLICY LIMIT S 1,000,000 <br /> OFFICERS ARE: E%CL EL DISEASE~EA EMPLOYEE f 1,000,000 <br /> OTHER <br />DESCRIPTION OF OPERATIONSA.OCATIONSIVEHICLESISPECIAL ITEMS pe: Workers' Compensetl0n <br />OYG Psrmit No. 0-81-022 Cartif ieeta of Insurene• repl Bees end vol ds prerlously Issued <br />eertif ieetas. <br />~CEATlFICRTE:HOI:DER::.: ~.:~:~: ~::~~:.::.:::':':: ~.: ~: ~:~:::: ~:..::::.::':::':~ :~ ~: : ~:: ~.:':'.::.::.::: CANCELL~A7tON:: ~.':' ~.:::':::':'~:':'::::::::: ~:::::::~::.: ~. ~: ~ ~:~~ ~ ~: ~:::~: ~::~::~::'.::: ~::'::::~ <br /> SHOULD ANY OF THE ABOYE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />Dl vlcl on of Yinarels 6 EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL E1W6YXf(WNXdX)11AIL <br />Gec I oyy 30 DAYS WRRTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />Attn: Oer• Berry YWMXItlOVM1UWIM11YYW1m1YY1Yf1(Y111(WOWtlCYM10IX1801tlXYWfIYXMI(IIIW81CWM1(% <br />1313 Ghermen Street MOXXXWXWII% XXR7(XIUWUNOW(%WWX)RWBBWdWNWWOXIWGC <br />Roam 215 A ORIZEO RE A <br />Oenrer, CO 90203 <br />::ACORD 2g:g ~ .1198 ::: ~~::::.:.::: ~ ~~.::..:.: ~.:..:.::.: ~ :.::' ::: ~.: ~.:.' .:.... ...:..:..' ....:... : ~ ::.: .'..~~. ~}liGOND CORPORATION ~t 968: <br />r' <br />CERTIFICATE: 0031003/ 00017 <br />
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