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GENERAL41948
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Entry Properties
Last modified
8/24/2016 8:10:21 PM
Creation date
11/23/2007 11:31:15 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1982056
IBM Index Class Name
General Documents
Doc Date
7/3/1995
Doc Name
CERTIFICATE OF INSURANCE
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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iii iiiiiiiiiiiiiiii <br />' - ~ r 999 RECEIVED <br />U.~~~t~t>C~I~~ D~1 ~~tSLt~~YXC~E JUL 0 3 1995 <br />To: Division of Minerals & Geology Date: June 30, 1995 Division of Pnlnerals tt Geology <br />Aaares5: Department of Natural Resources Re, See Attachment <br />1313 Sherman St., Room 216 <br />Denver, CO 80203 <br />This is to certify that the policies designated below are in force on the date borne by this Certificate. <br />NAME OF INSURED: CypCUS P1IIlaX MmeralS COmpaRy eL al 1RC1Uding $UbSldlary COmpames <br />9100 East Mineral Circle <br />Address: Englewood, CO 80112 <br />TYPE OF INSURANCE POLICY • POLICY PERIOD POLICY LIMITS /VALUES <br />A) Commercial General Liability - 07/01/95 - $ 6,000,000 General Aggregate <br />including Product/Vendor and XC 07/OI/96 $ 6,000,000 Product/Completed Operations <br />Coverage, Claims Made, Retro GL1212703 Aggregate <br />Dale: 7/1/86 GL1212702 $ 1,000,000 Personal and Advertising Injury <br />a) All States $ 1,000,000 Each Occurrence <br />b) Texas $ 1,000,000 Fire Damage (Any One Fire) <br /> $ 10,000 Medical Expense (Any One <br /> Person) <br />B) Auto Liability 07/01/95 - $2,000,000 CSL Each Occurrence <br />a) All States CA1351198 07/01/96 <br />b) Texas CA1351196 <br />C) Workers' Compensation 09/OI/94 - WC: Statutory <br />Employers' Liability 09/01/95 EL: $2,000,000 Each Accident <br />California Only C016120-02 $2,000,000 Disease -Policy Limit <br /> $2,000,000 Disease -Each Employee <br />D) Workers' Compensation 09/01/94 - WC: Statutory <br />Employers' Liability 09/01/95 EL: $2,000,000 Each Accident <br />Other States C016119-02 $2,000,000 Disease -Policy Limit <br /> $2,000,000 Disease -Each Employee <br />E) Excess Workers' Compensation EX-335 09/01/94 - Company's Limit of Indemnity Each <br /> 09/01/95 Occurrence: Statutory <br /> Self Insured Retention: $1,000,000 <br />T!(11UF24NlU~CH76L7tDC19i tY+K9ct42tX]CYBF%3JdC2iNC5'gAlS~5~C701dC7i7pUAd~l1[9~7Cx <br />nomol[ameat~efaaae~Ddzao[nest:b xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxX <br />liaoility of any Iona upon the company, or upon tnis agency <br />SEVERAL LIABILITY NOTICE (LSW 1001) <br />The subscribing insurers' obligations under contracts of insurance to which they sub- <br />scribe are several and not joint and are limited solely to the extent of their individual <br />subscriptions. The subscribing insurers are not responsible for the subscription of any <br />co-subscribing insurer who for any reason does not satisfy all or part of its obligations. <br />INSURANCE COMPANY(IES) ISSUING COVERAGE: <br />A)B) National Union Fire Insurance Company of Pittsburgh PA <br />C)D)E) Old Republic Insurance Company BY <br />i <br />~~~~1~ <br />AON NATURAL RESOURCES WORlDWlDE <br />2000 Bering Dr., Suite 900 <br />Houston. Texas 77057 <br />~ P.O. Bon 36429 <br />Hauson. Texas 7723664'_9 <br />Phony 713/783-6640 <br />P Telecopier: 713/763 7241 <br />148-BA.CLG <br />ANR~023 (Rav. 6/95) <br />
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