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GENERAL42106
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GENERAL42106
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Entry Properties
Last modified
8/24/2016 8:10:39 PM
Creation date
11/23/2007 11:35:41 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981012
IBM Index Class Name
General Documents
Doc Date
9/7/1993
Doc Name
CERTIFICATE OF INSURANCE
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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L~jtnergc.f <br />~~~~IIIII1111 X11 <br />,j ISSUE DATE (MM/DD/YY) <br />I. .REVI$ELb <br />999 +~#FlC~-TE O~ INSUF#A~±#C~ <br />,...._;~z_ ~:.e ~ _ :. . -.,.~ , <br />- _ ... ~.:-.,... ... 9101193 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTEfl OF INFORMATION ONLY AND <br /> CONFERS NO RIGHTS UPON THE CEflTIFIC <br />TF, HOLDER. THIS CERTIFICATE <br /> ~ <br />DOES NOT AMEND, EXTEND OR ALTER TH COVERAGE AFFORDED BY THE <br />RHH of Washington, Inc. PoLICIESBELOw. <br />3131 Eiliott Avenue, Suite 500 COMPANIES AFFORDING COVERAGE <br />Seattle, WA 98121-1047 _ <br /> COMPANY <br />A <br />206-281-4500 LETTER <br />Federal Insurance Company <br />- <br /> COMPANY H <br />INSURED LETTER <br />Hasin Resources, Inc. LEMERNYC RECE!VEC' <br />Attn: R.W. Hopper <br />14300 Highway t2 COMPANY <br />~(~(~~ <br />D <br />Weston, CO 81051 ~ <br />LETTER <br />SEP JJ <br /> COMPANY E <br /> LETTER <br /> <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEp ABOVE FOR THE POLICY PERIOD <br />INDICATED, NOTWITHSTANDING ANV REQUIREMENT, TERM OR CONDITION OF ANV CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAV PERTAIN, THE INSURANCE AFFORDED BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO 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 <br />LTR POLICY EFFECTIVE POLICY EXPIRATION LIMIT9 <br />DATE IMM/DDIVY) DATE (MMIDD/VV) <br />GENERAL LIABILITY GENERAL AGGREGATE S 2000000 <br />A X COMMERCIAL GENERAL LIABILITY 371 O 1 173 9/O l 193 9/O 1 /94 PRODUCTS~COMPIOP AGG. S 1 000000 <br />CLAIMS MADE X OCCUR. PERSONAL d ADV. INJURY S 1 000000 <br />~( OWNER'S d CONTRACTOR'S PROT. EACH OCCURRENCE S 1 000000 <br /> FIRE DAMAGE (Any one flre) S 250000 <br /> MED. EXPENSE (My one person) S 1 0000 <br />AUTOMOBILE LIABILITY COMBINED SINGLE <br />S <br />ANY AUTO LIMIT <br />ALL OWNED AUTOS BODILY INJURY <br />S <br />SCHEDULED AUTOS (Per person) <br />HIRED AUTOS <br />BODILY INJURY S <br />NON~OWNED AUTOS (Per eccltlenp <br />GARAGE LIABILITY <br /> PROPERTY DAMAGE 5 <br />EXCESS LIABILITY EACH OCCURRENCE 5 <br />UMBRELLA FORM AGGREGATE S <br />~ - <br /> <br />OTHER THAN UMBRELLA FORM n <br />.. <br />li ' <br /> STATUTORY LIMITS Rq'Fj -' <br />WORKER'S COMPENSATION -- -- <br /> .EACH ACCIDENT f <br />AND <br /> DISEASE-POLICY LIMIT S <br />EMPLOYERS' LIABILITY '" " <br />' DISEASE-EACH EMPLOYEE S <br />OTHER <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS <br />Re: The New Elk Mine Permit tiC-81-012 <br /> <br /> <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> ,~ EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ]~I;~;KVgig}(I~ <br />State of Co 1 orado 30 <br /> DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE <br />MAIL <br />Mined Land Rec 1 ama t i on Office LEFT ~¢{1}pQpp~pll~~~gAJ}{~I)(L=g}1r~~{I~{~IJ¢!!~}(~+ <br />Attn: Joseph Dudash r!~}Pli~ ~q~,E ~7:~RiIRgPR~RkkTii~€A <br />1313 Sherman Street, Room 215 <br /> <br />Denver, CO 80203 AUTH ED REPRESENTATIVE <br />'~ 398250080 <br /> Yli r <br /> <br />M, ti _ <br />~~/~ ~y'EG ~~~: <br />,. 1fi ", ~ .~ Iwo i,i-~, . ,~~ ~,I <br />
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