GENERAL45044

• Permit No: C1996084
• IBM Index Class Name: General Documents
• Doc Date: 2/9/1998
• Doc Name: CERTIFICATE OF LIABILITY INSURANCE
• Permit Index Doc Type: INSURANCE
• Media Type: D
• Archive: No

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:ERTIFaCATE D
LaABILITY
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PRODUCER 89,82 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Willis Corroon Corporation of Birmingham ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
,927 First Ave. North HOLDER. THIS CERTIFCATE GOES NOT AMEND, EXTEND OR
P.O.Box 11567 (35202( ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Birmingham AL 35203 COMPANIES AFFORDING COVERAGE
[phone]
coMPANV National Union Fire Ins. Co. of Pittsburgh, PA
Betty Hollis A

INSURED COMPANY
B
LORENCRO COAL COMPANY, LLC COMPANY
,311 BENTWOOD DRIVE C

EVANSVILLE IN 477„ COMPANY
D
,.. .
~. RAGES ~~:~~:::~~~~~:::~'.~~~::'~~::::::;:..:~ ::.:::::::.::::~:::~:::'~::~.::':::.:~:..:.:;:.:::~~::~.:::.:::,'::.:~;.~~::::~~:~~~~~~~~::::.:,:.:::::;~::~:::::.:::...:..::~:~:~:~.:..:~~.:~.; ~:.:.:.: ...,..:. ~. ~~::.. ..
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TH1S IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAIAED ABOVE FOR THE POUCY PERIOD
INDICATED. NOTWITHSTANDING ANV REQUIREMENT, TERM OR CONDITION OF ANV CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAV PERTAIN, THE INSURANCE AFFORDED BY THE POLJCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAV HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OFINSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMn3
LTR DATE (MMIDD/W) DATE (NM/DD(YY)
A GEN ERAL LIABILDY GL5652470RA 24JAN-,997 01JUL-1998 GENERAL AGGREGATE 3 2.000. ODD
X COMMERCIAL GENERAL LIABILITY PROOUCiSCOMP OP AGG S S,000,OOO
CLAIMS MADE ~ OLLUR PERSONALb ADV INJURY S 1.ODO.000
OWNER'SB CONTRACTOR'S PROS EACH OCCURRENCE S 1,ODO, OOO
FIRE DAMAGE An ons fire S 50,000
MEO E%P An one rson 5.000
AUT OMOBILE LUIBILT' COM&NED SINGLE LIMIT f
ANY AUTO

ALL OWNED AIIrOS RECE ED BODILY INIURV
P
n f
SCHEDULED AUTOS er perso
)
(

HIRED AIfTOS BODILY INJURY f
NONDWNED AUTOS FEB 0 9 1998 (Per accrEAnt) '

PROPERTY DAMAGE
S
GA RAGE LIABILITY AUTO ONLY -EA ACCIDENT f

ANy gUTO OTHER THAN AUTO ONLY:

EACH ACCIDENT f
AGGREGATE
EXCESS DA8IUTY EACH OCCURRENCE S

UMBRELLA FORM AGGREGATE S

OTHER THAN UMBRELU FORM
WC STATU~ OTM-
WORNERSCOMPENSATN)NAND TORY L'MITS R '
EMPLOYERS' LIABIDTV ~
-
EL EAGti ACCIDENT
$
THE PROPPIETOR/
P
T
E
INLL
EL DISEASE~POLICV LIMIT
S
ARTNERSI
%ECU
IVE
OFFlCERS ARE'. E%CL EL DISEASE {AEMPLOYEE
OTHER
DESLRIPTN)N OF OPERATIONSILOCATN)NS/VENN;LESISPECIAL REMS
RE: Permit No. C-96-064 Location: 2 miles West of Segundo, CO. on Highway 12
::CEHTfffCATE:HOLOEtl. ... ~;.:; ~:. . ;: ..:: ::.r. .. ' CANCELLATION . .....;.: ... .. ..
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
E%PIRATN)N DATE THEREOF, THE ISSUING COMPANY WILL 7E7U40TLY Ira MAIL
COLORADO DIVISION OF MINERALS AND GEOLOGY 3D DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
7313 SHERMAN STREET BITR FANLaF%NXYMCISIxi1LNOYN'FI(Ya/ImX aOx7aH nofaafrcxxlaX%rN SmB-%Xx XXI
ROOM 215 OA xXRYZNNNa7LANIfNN %1fTQ% zYP6%xAaaN151x DT1%YaHO1RBBBNp>MlalBfX%%)
DENVER CO 80203 AUTH ZED REPRESENT E~/

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