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GENERAL35169
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GENERAL35169
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Entry Properties
Last modified
8/24/2016 7:56:17 PM
Creation date
11/23/2007 8:12:42 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981032
IBM Index Class Name
General Documents
Doc Date
6/3/1986
Doc Name
CERTIFICATE OF INSURANCE
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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<br />~ I I IIIIIII <br />Alexander k AleAander Inc. <br />2120 South 72 Street <br />O~aha, NE 88124 <br />INSURED <br />NORTHERN COAL COMPANY <br />2600 0006E STREET <br />OMAHA, NE 68131 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS <br />NO RIGHTS UPON THE CERTIFlCATE HOLDER. THIS CERTIFIGTE DOES NOT AMEND, <br />EXTEND OA ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />COMPANIES AFFORDING COVERAGE <br />COMPANY A <br />LETTER TRAVELERS INDEMNITY OF RHDDE ISLAND <br />LETTERNY B <br />TRAVELERS INDEMNITY COMPANY Fr: ^- ~~_~.: =''^:~"""`~~• <br />COMPANY C G ~~'^,. .., .~• t t':.: `-=:> <br />LETTER <br />i°-T~~aNr o J~U 43 X986 <br />COMPANY <br />LETTER E .eu or•ra n f.a9:T .•1!"'x'+1 .>wC fermi <br />THIS IS TO CERTIFY THAT POLICIES <br />)THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDN:IITED. <br />fHER DOCUMENT WfTN RESPECT TO WHICH THIS CERTIFGTE YAY <br />HEREIN IS SUBJECT TO ALL THE TERMS, E%CLUSIONS, AND CONDO <br />CO POLICY EFRLTNE PoLICV F%R0.ailON LIABILITY LIMITS IN THOUSANDS <br />LTR TYPE OF INSURANCE POLICY NUMBER OaTE IMAWDA'1~ Dart (MMaXWYI r, ". <br />' ADR <br />OCCURRENCE AGOREMTE <br /> GE NERAL LIABILITY <br />BODILY <br />p Y COMPREHENSNEFORM TREE-NSL-133T873A-B6 b-1-86 b-1-87 Iwupr $ $ <br /> <br /> PREMISES/OPERATIONS ppppERTY <br /> Y EXPLOSIONU6 COLLAPSE HAZARD DAMAGE $ $ <br /> <br /> Y PRWUCTS/COMPLETED OPEMTIONS <br /> Y CONTRACTUAL <br />BCOMB NED <br />`$ 1,DDD <br />$ I,DDD <br /> INDEPENDENT CONTRACTORS <br /> Y BROA- FORM PROPERTY OANUGE <br /> Y PERSONAL INJURY PERSONAL INJURY ,~ IiDOD <br /> Y BRDAD FORM VENDORS <br /> A UTOMOBILE LIABILITY ~ . <br />h`, <br />A Y ANY Auro TR-CAP-1b2TBl3-D-Bb b-t-86 b-1-81 ~ePE>~an $ , <br />L <br /> ALL OWNED AUTOS (PRN. PASS.) eaRLr • <br /> <br />OTHER THAN <br />ALL OWNED AUTOS ~ PRN. PASS <br />~ <br />)LEIRr <br />IRR rGOCERn <br /> <br />$ A• <br />; <br />- <br /> Y . <br />HIRED AUTOS PROPERTY -- <br /> Y NON~OWNEO AU70S DAMAGE $ <br /> GARAGE LIABILITY BI 8 PD <br /> B TEYA5 AUTD ONLY -TREE-NSL 133TB73A-86 COMBINED $ 1 000 <br /> EXCESS LIABILITY <br /> UMBRELLA FORM BI a PD <br />COMBINED <br />$ <br />$ <br /> OTHER THAN UMBRELLA FORM <br /> <br /> <br />' <br />l"" <br />STATUTORY <br />"^r 1 <br /> <br />A COMPENSATION <br />WORKERS <br />TREE-UB-191T357-9-Bb <br />6-1-8b <br />b-I-B7 <br />'+ ># <br />$ 1000 (EACH ACCIDENT) <br /> AND <br />' ( $ IOOD (DISEASE-POLICY LIMIT) <br /> EMPLOYERS <br />LIABILITY >;', $ (GOO (DISEASE~EACH EMPLOYEE <br /> OTHER <br />DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECU\L ITEMS <br />ALL OPERATIONS <br />COLORADO DEPT OF NATURAL RESOURCES, OFF[CE DF <br />MINED LANG RECLAMATION DIVISION <br />1313 SHERMAN STREET <br />DENVER, CU 80202 <br />C` <br />E <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EX- <br />PIRAIIIlON GATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO <br />MAIL 3U DAYS, EN NOTICE TO $$THE C FIGTE HOLDER NAMED TO THE <br />OF AN K ND U ~ COMP HlYp, ITS/{OE! S A REPRESENTATIVES UABN.ITY <br />I7MORIZED REP S /ATIVE ~ ~~ <br />
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