GENERAL36384

• Permit No: C1984062
• IBM Index Class Name: General Documents
• Doc Name: CERTIFICATE OF INSURANCE
• Permit Index Doc Type: INSURANCE
• Media Type: D
• Archive: No

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PRODUCER D
CO
NFERS
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AN
NO RIGHTS U PON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
SEDGWICK JRMES DF TN, INC. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW --
P. O. BOX 1461@ COMPANIES AFFORDING COVERAGE
KNOXVILLE, TN 37939
[phone] CDMPANY
A R: OLD REPUBLIC INSURANCE CO.
CODE SUB-CODE LETTER
'
- E
_.__._._.....
----_.
-
._--__..___- -
_-._. COMPANY B ~~~ P ~p ~~~
H
~~cc AAII~~ ll~~ PPP ll'r~ YEO~
INSURED LETTER
CYPRUS MINERALS CO. COMPANY
C ~ i~1v
C; )UL

AND ITS SUBSIDIARY CO.
LETTER .
,
P. 0. HOX 3299 COMPANY D D;
MINED LA~,N~.
ENGLEWDOD, CD 80155 LETTER n
'?E,, 141u1eTlnnl nl,m~~ y ___
- ~-~ `_~~~ ~ ~- ~~

COMPANY E E:
LETTER
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANV CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAV PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
E%CLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAV NAVE BEEN REDUCED BV PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE 'POLICY E%PIRATION ALL LIMITS IN THOUSANDS
LTR DATE IMMIDDIYY) DATE IMMIDDIYY)
GENERAL LIABILITY GENERAL AGGREGATE S 0-
'~ I COMMERCIAL GENERAL IIABILTTY I i ~ PRODUCTS-COMP/ORS AGGREGATE. S
`! _. CLAIMS MADE^ !OCCUR.!. 'PERSONAL 8 ADVERTISING INJURY'S _ 0_
''~ OWNER'S b CONTRACTOR'S PROT.' '' / / / / EACH OCCURRENCE S
_~ I ..._... ___ _____-
i ~ :i 'FIRE DAMAGE (Any one Lre) S
__. _. _______-.___ . , ... ._ _ ... .__.. _....... ._- ___ _ - _ .___. 0......
,MEDICAL EXPENSE (Any one penonl : S 0
AUTOMOBILE LIABILITY COMBINED I
---'- ~ SINGLE S '
• ~ ANY AUTO ~ LIMIT 0
I All OWNED AUTOS ~ BODILY ,~

^- INJURY 5
' SCHEDULED AUTOS
~ / / ~ / / (Per penonl _ _ _ Q
I HIRED AUTOS BODILY
--
I NON-OWNED AUTOS i
_ INJURY S ~
~ (Per eccitlenq -- 0
' GARAGE LIABILITY i
~
~ PROPERTY

I~ ~ i
DAMAGE
,
- _._ ....:.... .. .. ... ... .. _.- ___ . - __. 0.._. _. .:.
E%CESS LIABILITY EACH AGGREGATE
OCCURRENCE

_ '~ OTHER THAN UMBRELLA FORM '
_ _. _.._____....___.._-....__-_ i
_
_~
0
@
___ __
____
.-.._._- _._._- ___
.__. __. __.-_
.__

WOR%ER'S COMPENSATION STATUTORY I
_
(EACH ACCIDENT)
l OQ10
5
AND _
. _
...- ., .-.
- -
A 0000404603
' (DISEASE-POLICY LIMIT)
1 Q0Q
07 /01 /90 07101 /915

EMPLOYERS
LIABILRY _
_
.._ .......__-.
__ _ _ S
1 000 (DISEASE-EACH EMPLOYEE
OTHER - __
'- -
R EXCES5 W. C. (1) EX260 07/01/90 07/01/91 $1,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEMICLESlRESTRItt10N5ISPECIAL ITEMS
(1) EXCESS W.C. RPPLIES TO THE FOLLOWING STATES: CO, KY, PA, UT,RL,AZ,GA,ID,MT,
TN, NV - TWENTYMILE COAL CO., FOIDEL_ CREED MINE PERMIT #C-B^c-056, COLORADO
STATE OF COLORADO
MINE LRND RECLAMATION DEPT.
1313 SHERMRN STREET, SUITE 215
DENVER, CO 80203

SHOULD ANV OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
t E%PIR'A~T~ION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
~ MAIL ~~F~L DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
'F' LEFT, tiW FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE.`NO OBLIGATION OR
- LIABILITY AN~.I(IND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
~` AUTNO)R~I2~ED REPRESENTATIVE ~ y /. ~ ~ ~
_ /~r_
.: --. .-~.-.. __.: _..:rav~,r-ate: m.n... _.~... .n. -r.~ _.
- ~ ~ ~ ~ ®AC D CORPORATION 198H