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GENERAL44400
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GENERAL44400
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Entry Properties
Last modified
8/24/2016 8:13:11 PM
Creation date
11/23/2007 12:59:54 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981047
IBM Index Class Name
General Documents
Doc Date
6/10/1982
Doc Name
CERTIFICATE OF INSURANCE
From
FRANK B HALL & CO OF MASSACHUSETTS INC
To
MLRD
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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CXOfd, <br />NAME AND ADDRESS OF AGENCY <br />Frank B. Hall & Co. t>f lQasa., Znc. COMPA NIES AFFORDING COVERAGES <br />89 Broad Street <br /> <br />Boston, Mess. 02110 <br />LEOTTERNY w <br />AInSllrance Company of North America <br /> E„eR"Y B Pacific Employers I <br />NAME AND ADDRESS OF INSURED <br />N /~ <br />Blue Ribbon Company Y <br />LEITER ^ <br />V <br /> <br />A Colorado General Partnership <br /> <br />Paonia, Colorado <br />L~TTEPNY D <br /> COMPANY <br />LETTER E <br /> <br />Thls is to certity that policies of insurance listed below have been issued to the insured named above and are in force at this lime. Notwithstanding any requirement, term or condition ' <br />of any cantrect or other document with respect to which this certificate may be issued or may perta in. the Insurance afforded by the policies described herein is subject [o all the <br />terms. a%clusions and conditions of such policies. <br /> <br />COMPANY <br />POLICY Limits of Liability in 7 ousan s 0) <br /> <br />LETTER TYPE OF INSURANCE POLICY NUMBER <br />E%PIRATION DATE EACH <br />AGGREGATE <br /> OCCURRENCE <br /> GENERAL LIABILITY <br /> BODILY INJURY S S <br />A ®COMPREHENSIVE FORM 6/1/83 <br /> ^PREMISE$-OPERATIONS PROPERTY pAMAGE 3 S <br /> E%PLOSION AND COLLAPSE ISL 209169 <br /> HAZARp <br /> ^ UNDERGROUND HAZARD <br /> PRDDVCTS~COMPLETED <br /> OPERATIONS NAZARD <br />^ BODILY INJURY AND <br /> CONTRACTUAL INSURANCE PROPE RTV DAMAGE S 1,000 S 1,000 <br /> BROAD FORM PROPERTY COMBINED <br /> DAMAGE <br />^ INDEPENDENT CONTRACTORS <br /> PERSONAL INJURY PERSONAL IN JURY s <br /> AUTOMOBILE LIABILITY BODILY INJURY <br />= <br /> (EACH PERSONI <br /> ^ COMPRF HE NSIVE FORM BODILY INJURY b <br /> ^ OwNED (EACH ACCIDENT) <br /> ^ HIRED PROPERTY DAMAGE f <br /> BODILY INJURY AND <br /> NON OWNED PROPERTY DAMAGE L <br /> COMBINED <br /> EXCESS LIABILITY <br /> RODILY INJURY AND <br />B ~ UMRRELIA FORM erwcrwwmn <br />~ BE DETFR!>BiED 6/1/83 FROFCRTI'DAMAGC E 5,000 f 5,000 <br /> OTHER THAN UMBRELLA COMBINED <br /> FORM <br /> WORKERS' COMPENSATION STATUTORY <br /> and <br /> EMPLOYERS' LIABILITY s <br />II.cH+ccmer+r~ <br /> OTHER <br />DESCRIPTION OF OPERAiIONSiLOCATIONSNEHICLES <br />Cancellation: Should any of the above described policies be cancelled~ef~$~~~~r}tJFtl~~~ereof, the issuing com- <br />pany will ~ mail ~ days written notice to the below named certificate holder.~~j~ <br />NAME AHD ADDRESS OF CERTIFICATE HOLDER <br />Colorado Department of Natural Resources GATE ISSUED' <br />Mined Reclamation Hoard F.B. Hall & Co. of Mass., Inc. <br />Mined Land Reclamation Development <br />1313 Sherman Street <br />~ <br />~. <br />, <br />Denver, CC1Orad0 H0203 AUTHOR ZED REPRE$ <br />ACORD ZS (149) <br />
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