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GENERAL40448
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Last modified
8/24/2016 7:59:38 PM
Creation date
11/23/2007 10:40:03 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981041
IBM Index Class Name
General Documents
Doc Date
10/7/1993
Doc Name
Certificate of Insurance
From
PEABODY HOLDING CO INC
To
DMG
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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r. A1:111:D. CERTIFICATE OF INSURANCE ISSUE OA/T~E~(MMIS`DDeIV~Y) 93 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND <br />CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE <br />BHJ , I NC . DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE <br />POLICIES BELOW. <br />P.O. BOX 6006 <br />SHERIDAN, WY 82801 COMPANIES AFFORDING COVERAGE <br /> COMPANY <br />LETTER A <br />INSURANCE CO. OF NORTH AMERICA <br /> G-5 <br /> <br />INSURED COMPANY <br />LETTER B '~""TT /~ <br />I~ F C 1- ~ '~i I- ~ ' <br />POWDERHORN COAL COMPANY <br />SUBSID. OF WESTERN ASSOC. <br />A~ <br />COAL CORP~TTERNV^ <br />OCT 7199 <br />CALLER BOX 3034 <br />GILLETTE, WY 82717 LETTERNYD <br /> L PnoiU~i ~: :'t .- ~ .. V _. L' `r <br /> COMPANY E <br /> LETTER <br />COVERAGES <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 ANV REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED 8Y THE POLICIES DESCRIBED HEREIN IS SUBJECT 70 ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAV HAVE BEEN REDUCED BY PAID CLAIMS. <br />CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY E%PIRATION LIMITS <br />LTR DATE (MM/DD/YY) DATE (MMIDD/YY) <br />GENERAL LIABILITY GENERAL AGGREGATE E N/A <br />A X COMMERCIAL GENERAL LIABILITY CGO G1 658513-0 1D/D1 /93 1D/D1/94pRODUCTS-COMP/OPAGG. E 2,DDD,DDD <br />CLAIMS MADE X OCCUR. PERSONAL 8 ADV. INJURY f 1 r 000 r 000 <br />OWNER'S 8 CONTRACTOR'S PPOT. EACH OCCURRENCE E 1 ~ ODD s D00 <br />X Broad Form Vendors Coverage Included FIRE DAMAGE (Any one lire) f SD,DDD <br /> 5 000 <br /> MED E%PENSE IAny one penwn) f , <br />AUTOMOBILE LIABILITY COMBINED SINGLE <br />A X SCA HO 502377-4 10/01 /93 1 0/01 /94 LIMIT f 1 000 000 <br />ANY AUTO , , <br />X <br />ALL OWNED AUTOS BODILY INJURY <br />X <br />SCHEDULED AUTOS (Per person) f <br />X <br />HIRED AUTOS BODILY INJURY <br />X NON~OWNED AUTOS (Par accitlenl) f <br />GARAGE LIABILITY <br /> PROPERTY DAMAGE E <br />E%CESS LIABILITY EACH OCCURRENCE S <br />UMBRELLA FORM AGGREGATE E <br />OTHER THAN UMBRELLA FORM <br /> STATUTORY LIMITS <br />WORKER'S COMPENSATION <br /> EACH ACCIDENT S <br />AND <br /> DISEASE-POLICY LIMIT S <br />EMPLOYERS' LIABILITY <br /> DISEASE-EACH EMPLOYEE f <br />OTHER <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS COVERS ALL OPERATIONS IN STATE OF <br />COLO. INCLUDING POWDERHORN COAL CO., ROADSIDE AND CAMEO N0.1, INCLUDES <br />DAMAGES FROM SURFACE COAL MINING OPERATIONS, USE OF EXPLOSIVES & DAMAGE TO <br />WATER WELLS. <br />CERTIFICATE HOLDER CANCELLATION <br />COLORADO DEPT OF NAT'L RES. <br />DIV OF MINED LAND RECLAMATION <br />215 CENTENNIAL BLDG <br />DENVER, CO 80203 <br />ACORD 25-S (7/90) <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />E%PIRATION DATE THEREOF, THE ISSUING COMPANY WILL~gi~O~ryl/9'~TO// <br />MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THEE <br />LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR <br />LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. <br />AUTHORIZED REPRESENTATIVE ~/,fjj~{//%J(~p (n/ <br />I" "" ~ ORPORATION 1990 <br />
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