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GENERAL35732
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GENERAL35732
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Entry Properties
Last modified
8/24/2016 7:56:35 PM
Creation date
11/23/2007 8:26:05 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981010
IBM Index Class Name
General Documents
Doc Date
11/4/2002
Doc Name
Certificate of Liability Insurance
To
DMG
Permit Index Doc Type
Insurance
Media Type
D
Archive
No
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ACORD,a <br />Aeordia of WV-Bluefield <br />320 Federal Street <br />PO Box 1439 <br />Bluefield WV 24701 <br />1304) 327-3421 <br />Capstan Mining Company <br />e/o Yassey Caal Services <br />315 70th Street <br />Charleston, WV 25304 <br />THIS IS TO CERTIFY <br />iURANCE LISTED BELOW HAVEBEENISSUEDTOTHEINSURED NAMEDABOVEFORTHEPOLICVPERIOD <br />EMENT,TERMORCONDITION OF ANVCONTRACT OROTHER DOCUMENT W ITH RESPECTTO W HICHTHIS <br />IN, THE INSURANCE'AFFORDED'8Y-THEPOLICIES DESCRIBED HEREIN IS.SUBJECT T-O.ALL THE TERMS,_ _ <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> ~ TYPE OF INSURANCE <br />LTR POLICY NUMBER POLICY EFFECTIVE <br />DATE (MMRIDIYY) POLICY E%PIRATION <br />DATE (MMIDDIYY) LIMBS <br /> p GENERAL LIABILRY 6L5442363 11/01/01 11/01/03 GENERAL AGGREGATE Y 5,000,000 <br /> X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ 5,000,000 <br /> CLAIMS MADE X^ OCCUR PERSONAL 8 ADV INJURY $ 5,000,000 <br /> OWNER'S fl CONTRACTOR'S PROT EACH OCCURRENCE $ 5,000,000 <br /> FIRE DAMAGE (Any one tire) Y 5,000,000 <br /> MED EXP (Any one person) $ 5,000 <br /> AUT OMOBILE LIABILRY <br />ANY AUTO COMBINED SINGLE LIMIT $ <br /> ALL OWNED AUTOS <br /> <br />SCHEDULED AUTOS BODILY INJURY <br />(Per person) $ <br /> HIRED AUTOS <br /> <br />NON-OWNED AUTOS BODILY INJURY <br />(Per accitlent) q <br /> PROPERTY DAMAGE g <br /> <br /> GARAGE LIABLITY AUTO ONLY ~ EA ACCIDENT $ <br /> ANY AUTO OTHER THAN AUTO ONLY: <br /> EACH ACCIDENT $ <br /> AGGREGATE S <br /> EXCESS LIABILITY EACH OCCURRENCE $ <br /> UMBRELLA FORM 1 _~ AGGREGATE .$- <br />OTHER THAN UMBRELLA FORM <br />WORKERS COMPENSATION ANO <br />EMPLOYERS' LIABILITY <br />THE PROPRIETOR/ INCL <br />PARTNERS/EXECUTIVE <br />OFFICERS ARE: E%CL <br />OTHER <br />~ ~Baeon Yine Permit [o. C-81-030 <br />Colorado Yined Land <br />Attn: Ys. Cathy Bagej, RY 215 <br />Reelamation Division <br />Centennial Bldg, 1313 Sherman <br />St. Danvar, CO 80203 <br />Iq <br />WC STATU- OTH~ ' <br />TORY IM Ii <br />EL EACH ACCIDENT 4 <br />EL DISEASE~POLICY LIMIT $ <br />EL DISEASE~EA EMPLOYEE 4 <br />SHOULD ANV OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE 19sUIND COMPANY WILL ENDEAVOR TO MAR <br />10 DAYS WRITTEN NOTICE TO THE CERTIFLCATE HOLDER NAMED TO THE LEFT, <br />BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY <br />OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. <br />Jeffrey S. Eggleston <br />~~I/I~T;~ l4 \,1/~ IIY~/"A RI~WIaI>• W BB ~eY/MBS ~"\ll~~li llw 10/31/02 <br />~~ THIS CERTIFICATE IS ISSUED AS AMATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />COMPANIES AFFORDING COVERAGE <br />COMPANY <br />O /~ Ins. Co. of the State of PA <br />_~~`,t- COMPANY <br />(7 '` V"- B <br />`` V 1~' 'i ~ COMPANY <br />`vo_ ..t M~~BCa15 sad GeDlD9~ C <br />COMPANY <br />CERTIFICATE: 005/001/ 00001 <br />
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