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GENERAL34935
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GENERAL34935
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Last modified
8/24/2016 7:56:09 PM
Creation date
11/23/2007 8:06:51 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1996084
IBM Index Class Name
General Documents
Doc Date
8/14/2002
Doc Name
Certificate of Insurance
Permit Index Doc Type
Insurance
Media Type
D
Archive
No
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CERTIFICATE OF INSURANCE CERTIFICATE NUMBER <br />MARSH USA INC <br />. <br />RECEIVED ATL-000713565-02 <br />PRODUCER TNIS CERTIFICATE IS IBBUED AS A MATTER OF INFORMATION ONLY AND CONFERS <br />Marsh NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE <br />P.Q. BO% 36012 POLICY. TNIS CERTIFICATE DOER NOT AMEND, EXTEND OR ALTER THE COVERAGE <br />AUG 14 2002 <br />AFFORDED BY THE POLICIES DESCRIBED HEREIN. <br />Knoxville, TN 37930-6012 <br />COMPANIES AFFORDING COVERAGE <br />Division Gf Minerals and GeDlo y coMPANV <br />100004--- A STEADFAST INSURANCE COMPANY ' <br />INSURED COMPANY <br />LORENCINTO COAL COMPANY, LLC B N/A <br />20500 Hi <br />12 <br />h <br />way <br />gg <br />Weston, CO 81091 COMPANY <br /> C N/A <br /> COMPANY <br /> D <br />COVERAGES This certificate supersedes and replaces any previously issued certificate for the policy period noted below, 7 <br />THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. <br />NOTVATHSTANDING ANV REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAV BE ISSUED OR MAV <br />PERTAIN, THE INSURANCE AFFORDED BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. LIMITS SHONM <br />MAV HAVE BEEN REDUCED BY PAID CLAIMS. <br />CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS <br />LTR GATE IMMIDDIYY) DATE (MMIDDNY) <br />(~ GENERAL LIABILITY BOG 9304453-01 08/13/02 08/13/03 GENERAL AGGREGATE $ 2,000,000 <br /> J( COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ 1,ODO,ODO <br /> CLAIMS MADE OCCUR PERSONALBAOV INJURY $ 1,000,000 <br /> OWNER'SBCONTRACTOR'$PROT EACH OCCURRENCE $ 1,000,000 <br /> FIRE DAMAGE (Any one lire) $ 50,OOD <br /> <br /> MED EXP (An one arson $ 5,000 <br /> AUT OMOBILE LIABILITY <br /> COMBINED SINGLE LIMIT $ <br /> ANV AUTO <br /> ALL OWNED AUTOS BODILY INJURY $ <br /> (Per person) <br /> SCHEDULED AUTOS <br /> MIRED AUTOS BODILY INJURY $ <br /> IPer a¢itlent) <br /> NOMOWNED AUTOS <br /> PROPERTY DAMAGE $ <br /> <br /> GAR AGE LIABILITY AUTO ONLY-EA ACCIDENT $ <br /> ANY AUTO OTHER THAN AUTO ONLY: <br /> EACH ACCIDENT $ <br /> AGGREGATE $ <br /> EXCESS LIABILITY EACH OCCURRENCE $ <br /> UMGRELLA FORM AGGREGATE $ <br /> OTHER THAN UMBRELLA FORM $ <br /> WORKERS COM ENSATION AN D _ _ _ <br />- _ _ _ _ - l - - _ - <br /> <br />I _ _ <br />EMPLOYERS'LIABILITY~ _ TORY LIMITS ER <br />I EL EACH ACCIDENT $ <br />I THE PROPRIETORI INCL EL DISEASEPOLICV LIMIT $ <br /> PARTNERSIEXECUTIVE <br />$ <br /> OFFICERS ARE' EXCL EL DISEASE-EACH EMPLOYEE <br /> OT ER <br />DESCRIPTION OF OPERATIONS/LOLATIONSNEHICLESISPECIAL ITEMS (LIMITS MAY BE SUBJECT TO DEDUCTIBLES OR RETENTIONS) <br />RE: Permit # C-96-084 <br />Location: 2 Miles West of Segundo, CO on Highway 12 <br />Deductible: $5,000 Combined BI & PD Per Occurrence <br />CERTIFICATE HOLDER CANCELLATION <br /> SHOULD pNY OF THE POLICIES DESCRIBED HEREIN BE CMICELLED BEFORE THE E%PIRpTON OPTE THEREOF. <br /> THE INSURER AfFORDfNG COVERAGE WILL E~F%1U`MAIL ~O DAYS WRITTEN NOTCE TO THE <br />Colorado Division of Minerals & Geology CERTIFICATE HDLDER NAMED HEREIN. <br />1313 Sherman Street <br />Denver, CO 80203 <br /> MARSH USA INC. <br />i eY: Samuel F. Robinson ^^~^ <br /> MM1(9199) VALID AS OF: 08/12/02 <br />
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