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GENERAL42757
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GENERAL42757
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Entry Properties
Last modified
8/24/2016 8:11:33 PM
Creation date
11/23/2007 11:57:24 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981044
IBM Index Class Name
General Documents
Doc Date
7/12/2001
Doc Name
CERTIFICATE OF INSURANCE
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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iiiiiiiiiiiiiiuiii <br />999 <br />~ ~Certific~te of ~1u~ur~uce <br />Aon Rzsk Services <br />To: Division of Minerals & Geology Rg; Attachment <br />Department of Natural Resources Fax to: <br />Attention: Janet H. Binns Rick Mills at Twentymile <br />1313 Sherman St. Rm. 216 970-879-8050 <br />Denver, CO 80203 <br />RECEIVEb <br />Assured: RAG American Coal Holding, Inc. <br />sss corporate Blvd. ~UL 12 2001 <br />Linthicum Heights, MD <br />21090 Division of Minerals a Geology <br />This is !c certify that the policies o/ insurence listed below have been issued fo the Insured named above /or the policy pedod indica(ed, notwithstanding any <br />requirement, term, or condition of any contract or other document with respect to which this cerihcate maybe issued or may pertain. The insurance afforded <br />by the poicies described here/n is sub%ect to all the lama, exdusidu and cardiria~rs of such policies. Limns shown may have been reducetl by paid claims. <br />Type of Policy Policy Policy <br />Insurance No. Period LimitsNalues <br />Commercial General Liability GL 544 22 49 06130/01 - $ 6,000,000 General Aggregate <br />06/30102 $ 6,000,000 Products/Completed <br /> Operations Aggregate <br />$ 1,000,000 Personal and Advertising <br /> Injury <br />$ 1,000,000 Each Occurrence <br />$ 1,000,000 Fire Damage (Any One <br /> Fire) <br />$ 10,000 Medical Expense (Any <br /> One Person) <br />Insurance Company(ies) The Insurance Company of the State of Pennsylvania <br />Auto Liability AL 548-83-24 06/30101 - $ 1,000,000 CSL Each Occurrence <br />06130102 <br />Insurance Comoanv(iesl The Insurance Comoanv of the State of Pennsvlvania <br />Workers' Compensation OC 017049-04 06/30/00 - WC: Statutory <br />Employers' Liability 06/30/01 EL: $1,000,000 Each Accident <br />$1,000,000 Disease -Policy Limit <br />$1,000,000 Disease -Each <br />Employee <br />Insurance Company(ies) Old Republic Insurance Co. <br />Excess Workers' EX363-Ot 06/30/01 - Statutory Excess of a Self Insured <br />Compensation 06/30/02 Retention: $2,000,000 any one <br />occurrence <br />Insurance Comoanv(iesl Old Republic Insurance Co. <br />EXCESS W.C. APPLIES TO COLORADO <br />RAG EMPIRE CORPORATION INCLUDING PERMIT #C-81-044, TVVEfv iYMILE COAL COlv1PANY -INCLUDING <br />PERMIT #C-82-056 INCLUDING FISH CREEK TIPPLE AND OPERATIONS AT 29515 ROUTT COUNTY ROAD, <br />#27, OAK CREEK, COLORADO, COLORADO YAMPA COAL COMPANY INCLUDING MINES 1,2 PERMIT #C-81- <br />071 AND OPERATIONS AT OAK CREEK, COLORADO <br />The subscribing insurers' ob/igabons under contracts o/insurance to which they subscdbe ere several and notjoin~ and ere limited solely to the extent o/their <br />individual subscdptions. The subscribing insurers era not responsible !or the subscdption of any cosubscribing insurer who for any reason does nor safis/y all <br />or part of its obligations. <br />This celtillcale is issued as a matter of information only and wnfers no rights upon the certificate holder. This certificate dons not amend, extend or alter the <br />coverage afforded by the policy(ies) shown hereon. Should any of the above described policies be canceled before the expiration date Thereof, this agenq, on <br />behalf of the issuing company(ies), willxwrieromoda mail 60 days written notice to the above named cedifcate holder <br />iommsnmoblipemmmwrmebil~mpdreoyclmmmnPOrsYas~wpaof4~t~l~Napanoy. <br />Aon Risk Services of Texas, Inc. <br />Date: July 5, 2001 By: r ~; 7rf g~i.;,~ru,•~ <br />Aon Rirk Serviret of Texm, Int. <br />2000 Bering Dnve, Suim 900 • Housmn, Tezas 77057-3790 • tel: (7l 3) 430-6000 • fax: (713) 430-6590 <br />\\uCTNWFCt\CV C\r:l IFNTC\Gr1MRGr:\RnMAa Filac\~r1r11 (:aA FialOivision O(Min 8 GCO Cen.dOC-1 <br />
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