My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
GENERAL37428
DRMS
>
Back File Migration
>
General Documents
>
GENERAL37428
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
8/24/2016 7:57:33 PM
Creation date
11/23/2007 9:10:05 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981035
IBM Index Class Name
General Documents
Doc Date
8/15/2000
Doc Name
CERTIFICATE OF INSURANCE
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
2
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
ac~:i:i:® CERTII`[CATE OF <br />PRODUCER <br />Acordia of Colorado <br />5755 Mark Dabling Blvd. #300 <br />Colorado Springs, CO 80919 <br />(719) 592-1177 <br />INSURED <br />National King Coal, LLC <br />P O Box 2905 <br />Durango, CO 81301 <br />~NSURaNCE III IIIIIIIIIIIII III IBBDE DA,E LMMIDDfl1T <br />...............: <br />sss ;;.;..:.... os/11/2000 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND <br />CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE <br />. DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE <br />POLICIES BELOW. <br />COMPANIES AFFORDING COVERAGE <br />~~Y A Federal Insurance Co. <br />~°„~R Y B ECEIVED <br />LETTER Y ~ AUG 151000 <br />COMPANY Division of Minerals and Geology <br />LETTER D <br />coMPArTY E <br />LETTER <br />:COVEflAGES~' .:::::::..: .:.:':'.:'.'~.:'.: .i .::.. ~.:~.~ ..... : .. ........... .- ~ ... <br />:. ... <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED 70 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 MAY RE ISSUED OR MqY PERTAIN, THE LVSURANCE AFFOP.DED BY T.4E POLICIES DESCf`IDED HEREIY IS SUDJEC7 TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />CO TYpE OF INSURANCE PODCY NUMBEII RDMCY EFFECTIVE PODCY EXPIRATKOM DNRS <br />LTR: DALE (MMNDMII GATE IMMNDMT <br />A GENERAL WBIIITY GENERAi AGGREGATE f 2, 0 0 0, O O <br />~. X :COMMERCIAL GENERAL LUU3iLITY 9750-Bfr34PHA PRODUCTSCOMPpP AGG. f 1 , OOO , O0 O <br />.. CUIMS MADE X OCCUR, :O 8 /1 S /O O O 8 / 1 S / O 1. PERSONN_ 8 ADV. INJURY f 1, ODD , O O C <br />OWNER'S 8 CONTRACTORS PROT. 'EACH OCCURRENCE f 1 , ODD , O O <br />'FIRE DAMAGE (Any oee rue? f 1 O O, O O <br />MED. E%PEN$E (Any me person) f 1 O , O O ( <br />:AUTDMDBILE WBIIRY :COMBINED SINGLE ~ <br />:LIMIT f <br />. ANY AUTO <br />'ALL OWTlED AUTC$ BODILY INJURY <br />SCHEDULED AUTOS ~ ~ (Per person) f <br />.HIRED AUTOS <br />' BODILY INJURY <br />f <br />'NON-OWNED AUTOS (Per accitlenl) <br />~ , <br />. GARAGE LIABILITY ' <br />. .... :PROPERTY DAMAGE f <br />E1ICE59 WBLLIrY 'EACH OCCURRENCE f <br />:UMBRELLA FORM 'AGGREGATE f <br />' .OTHER 1HPN UMBRELLA FORM ' <br />. WORKER'S CONPENSATKIN STATUTORY LIMITS <br />_.- - --AND _ . _ _ _ ~ 'EACH ACCIDENT f .. ... .............. <br /> ' DISEASE ~ POLICY LIMIT S <br />EMPIAYFAS' WBILRY <br /> ' DISEASE -EACH EMPLOYEE f <br />OTHER <br />DESCRIPTKIN OF OPEAATIONSM1ACATKINBNENICL.ESISPECUIL IIF/A9 <br />OSM Permit CO-OlOlA CDMB Pe rmit C-81-035 <br />Cancellation clause is amended to eliminate "endeavor to" and wording <br />from "but failure to mail---" to end of clause. <br />CER7IEICA~TE :HOLDER::::'.::~::':' ::..:::.~.:~~"..'~::::::'':...'.~~~:':":.'.::: ~:~~~:C.ANCEl411TlpN~;';~,~.~:.~:.:..'~:~:~~~:::'~: ":'.':': ~:~'.........' ..... .. .. .......... .'. <br /> ~~ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> ~: EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO <br /> '.. MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE <br />D1v1810n Of Minerals & GE!OlOgy .~ LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR <br />1313 Sherman Street, Room 21S LIABILITY OF ANY HIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. <br /> '~: AUTNOR~D REPR <br />Denver CO 80203 <br /> <br />ACORD:'~`SI71.90):'.~::'::::':~:.::~:::~~:I:L:'.:'.:::.:.~:":.''::'::'..:':~.. ..:; IQ-(~~ <br />Y~ T-' <br />:~:~:':'..':.:~.:~."1:::':'~.':':'':::::".':.....:.::~':~:~:':'.: ;;'_::~.':.';~:~::::: ~.:':. $ ARD ~CORPORATtON~~:7680~'.. <br />
The URL can be used to link to this page
Your browser does not support the video tag.