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GENERAL34768
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GENERAL34768
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Entry Properties
Last modified
8/24/2016 7:56:04 PM
Creation date
11/23/2007 8:02:46 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981022
IBM Index Class Name
General Documents
Doc Date
7/17/1995
Doc Name
Certificate of Insurance
From
PARCEL MAURO HULTIN & SPAANSTRA PC
To
DMG
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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K•. <br />AI`111'll _ . $' <br />~ ~ - DATE (YLLND/1'Y) <br /> 7/12/95 <br />PRO4UCER Sedgwic k James of 6a. + Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Suite 900. South Tower ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />3333 Peachtree Rd. NE ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Atlanta, Georgia 30326 COMPANIES AFFORDING COVERAGE <br /> COMPANY <br /> A Federal Insurance Com an <br />INSURED <br />COMPANY <br />Oxbow Carbon & Minerals Inc. s <br />& Pacific Hasin Resources COMPANY <br />1601 Forum Place C <br />West Palm Beach FL 33401 COMPANY <br /> D <br />;COVE AGES .T~~~~ ,r ~~S ~` a ~~.., .. ._.. ,. _. .((~~GIO~O Mtt16fQSt„~:,+. ~ ~~i~. <br />M <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BEL ED ABOVE FOR THE POLICY PERIOD <br />OW HAVE BEEN ISSUED TO THE 117 RS'U ED NA <br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAV BE ISSUED OR MAV PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAV HAVE BEEN REDUCED BY PAID CLAIMS. <br />CO <br />LTR TYPE OFINSURANCE POLICY NUMBER PODCY EFFECTIVE <br />' PODCY EXPIRATION <br />' <br />' LIMR5 <br /> DATE (MMIDDM <br />) DATE (MMIDD/1 <br />1 <br />) <br />A GEN ERAL WBILfTY 37104268 7/21/94 7/21/95 GENERAL AGGREGATE E 'e7000000 <br /> X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMPNP AGG t 1000000 <br /> CLAIMS MADE X~ OCCUR PERSONAL 8 ADV INJURY E 1000000 <br /> OWNER'S6COMRACTOR'S PROT EACH OCCURRENCE E 1000000 <br /> FIRE DAMAGE (Any one Ina) E 100000 <br /> MED E%P IAny one person) E 1 OOOO <br />A AVT OMOBILEDABILRY BAP73077258 7/21/94 7/21/95 <br /> X ANY AUTO COMBINED SINGLE LIMIT E 1000000 <br /> X ALL OWNED AUTOS <br />BODILY INJURY <br />E <br /> X SCHEDULED AUTOS (Per parson) <br /> X HIRED AUTOS <br />BODILY INJURY <br />E <br /> X NON-0WNED AUTOS (Per ars+Eenl) <br /> <br /> PROPERTY DAMAGE E <br /> GARAGE LIABILTY AUTO ONLY ~ EA ACCIDENT E <br /> ANV AUTO OTHER THAN AUTO ONLY <br /> EACH ACCIDENT E <br /> AGGREGATE f <br />A EXCESSDABILfTY 79OEi3BO1 7/21/94 7/21/95 EACH OCCURRENCE E SOOOOOO <br /> X UMBRELLA FORM AGGREGATE f SOOOOOO <br /> OTHER THAN UMBRELLA FORM E <br />A WORKERS COMPENSATION AND 71634637 7/21/94 7/21/95 X STATUTORY LIMITS <br /> EMPLOYERS' DABILffY EACH ACCIDENT f SOOOOO <br /> THE PROPRIETOR/ <br />PARTNERS/EXECUTIVE INCL DISEASE ~ POLICY LIMIT E SOOOOO <br /> FF <br />' X <br /> ICERS ARE <br />O ~ E%CL DISEASE EACH EMPLOYEE E SOOOOO <br /> OTHER <br />DESCRIPTION OF OPERATIONS'LOCATIONSIVENICLE55PECIAL REMS <br />CERTIFICATE+HOCDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />~ 1 V l 5 1 o n O f Minerals & Ge o l D g y EXPIRATION GATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL <br />At t n : Tan y Wa 1 d r o n 3O pAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />1313 Sherman St. Room 215 RUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY <br />Denver, CO 80203 OF ANY KIND UPON THE COMPANY, OS AGENTS OR REPRESENTATIVES. <br /> <br />I AUTHORIZED REPRESENTATIV_ E /1 <br />~ -~ )~. /~ /may(/ ..'^"'„° <br />A <br />60' RD~2SS <br />(3(93) <br />~µ <br />_ . <br />. 33- ORD CORPORATION 1993. <br />o~1Q <br />14 ~ - -~ <br />: <br />„ <br />,~ <br />~ <br />,,,; <br />. <br />,,_ _ ,, <br />~, , „ , <br />, <br />,-,.,, <br />
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