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GENERAL35403
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Entry Properties
Last modified
8/24/2016 7:56:24 PM
Creation date
11/23/2007 8:19:09 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1996084
IBM Index Class Name
General Documents
Doc Date
7/12/1999
Doc Name
CERTIFICATE OF LIABILITY INSURANCE
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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<br />IIIII~~IIIIII III :ERTIFICAT~ OF L{ABIC trY INSURANCE <br />~ncE ; of ; 9";i <br />~;999 =- <br /> - <br />, <br />PRODUCER 121847 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Willis CDrroon Corp, of Birmingham ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />800 Shades Creak Parkway HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />Suite 6000 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />PO Box 11587 (35202) COMPANIES AFFORDING COVERAGE <br />Birmingham AL 35209 <br />National Union Fire Ins. Co. of Pittsburgh, PA <br />(205) 877-3671 COMPANY <br />LI58 J. Birchifield, CIC, CISR _ <br />--- --- --- <br />- I A __ <br />-- -- - <br />INSURED ~ <br />COMPANY <br /> B <br />LORENCITO COAL COMPANY, LLC <br />C/O AL PERRY coMPANv <br />9203 PETERSBURG ROAD C <br /> <br />EVANSVILLE IN 47711 cDMPANv <br /> D <br />COVEfiAGES:~. ~: ~..~ . ...: ..: ...:.. ~. .. ..:. ~. .:... ~ . ~. ~: .~. .: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <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 7HE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ <br /> <br />CO <br /> <br />LTR <br />~EDFIN$DRANLE POLICY NUMBER POLICY EFFECTIVE <br /> <br />DATE (NN(DD/'/'/) PODLY E%PIRATION <br /> <br />DALE (MMIDD/'/`O <br />LIMITS <br />A GEN ERAL LIABILITY GL544D34BRA 01~1U1-1998 01-SEP-1999 GENERAL AGGREGATE ~ = 2.000,000 <br /> X COMMERCIALGENERAL LIABILITY <br />~ PRODUCTSCDNP/D°AGG <br />~ 5 S, OOO,OOO <br /> ~ 000 <br />000 <br /> ClAIMSMADE OCCUR SONALB ADVINJURV <br />R . <br />2. <br />5 <br /> ~ ~ <br />~ _ <br />OOO <br />OOO <br />I <br /> CWNER'G6CONTRACTCR'S PROT I ACH OCCURRENCE <br />E . <br />. <br />f <br /> FlRE DAMAGE (AnY one hr~ j 5O • OOO <br /> ___ MED E%P A ona anon 5,000 <br />AU TOMOBILE DABILITV I <br />COMBINED SINGLE LIMIT <br />5 <br /> ANY AUTO I I <br />I <br />LJ <br />ALL OWNED AUTO$ <br />I <br />I _ _ <br />BODILY INJURY __ <br />5 <br /> SCHEDULED AUTO,R IPer person) <br /> HIRED AUTOS BODILY INJURY 5 <br /> <br />NONiTWNEO AUT05 <br />(Per acntlanD - <br /> <br /> ~PROPERTV DAMAGE <br /> j <br />I Gg RADE LIABILITY AUTO ONLY -EA ACCIDENT 5 <br /> <br /> ANY AUTO OTHER THAN AUTO ONLY. _ <br /> _ 1~O EALH ACCIDENT 5 <br /> \ <br />v AGGREGATE <br /> E%LES$LIABILITY ~~~ 'I [N1 1 <br />U <br />1 <br />~ EACH OCCURRENCE _~5 ___ <br /> UMBRELLA FORM -/- <br />, <br />7 !~~ <br />G <br />~ AGGREGATE _~5 __ <br /> ~OTHERTHAN UMBRELLA FORM I ~ IS& <br /> WORKERS COMPENSATKIN AND ~\Vr+•"' ~~ <br />~~ WC STATU~ OTH~ <br />TORY LIMITS R <br /> EMPLOYERS'LIABILITY `neTSls <br />0`~ __ <br />EL EACH ALCIDEN7 _ j ___ <br />- <br /> THE PROPRIETOR/ <br />PARTNERS <br />E%ECUTIV INCL ~ <br />NIg~O <br />Q ~ <br />EL DISEASE-POLICY OMIT j <br /> / <br />E <br /> OFFICERS ARE E%CL EL OSEASEFAEMPLOYEE <br /> OTNER <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL REMS <br />RE: Permit No. C-96-084 Location: 2 miles West of Segundo, CO. on Highway 12 <br />:.CERTiF'iCATE~HOLDER ~ .. .. ~ ~CANCF.II.ATION IOaay.railcellatlxuitoinonpgy. . <br /> SHOULD ANY OF THE ABOVE DESCRIBED PODCIES BE CANCELLED BEFORE THE <br /> E%PIRATNIN DATE THEREOF, THE ISSUING COMPANY WILL >EflOEISVBhY ja MAIL <br />COLORADO DIVISION OF MINERALS AND GEOLOGY 30 _ DAYS WRITTEN NOTICE TO THE CERTIFICATE NOLDER NAMED TO THE IFF7, <br />73 T3 SHERMAN STREET tYtRfAXDiI%tuI5xM1I 181101(MlTrt~]( OOX M,Ma7ea~i0araaXOtlexld%riaseeeY%TC%xx <br />pOOM 276 NBXAA'K1NI%%Mex xjSBC %AA[a1d(xbpz%pBN51-tIYBBtxx <br />DENVER CO 80203 AUTHOR ED PRESENTATIVE <br />I.. .. ..... ..~.. .. ... ... .. .. <br />~~ACOR025-.5~.(11135)~.-'~.~~~. __.,__.._.----VAfiiDUS2':~~~~.~~:. <br />~'~'.. <br />~:.~~:._'.~: ~~. ~. ~. ~:::::: ~. ~:;:.. :::':~~ :: :: ~'~A RDCORPORATION ieBB~~' <br />
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