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GENERAL47280
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GENERAL47280
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Entry Properties
Last modified
8/24/2016 8:22:11 PM
Creation date
11/23/2007 3:20:28 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1996084
IBM Index Class Name
General Documents
Doc Date
9/3/1999
Doc Name
CERTIFICATE OF LIABILITY INSURANCE
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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nuu~uuum <br /> <br />LIAB11 <br />ERTIFICATE OF <br />999 DATE (NM/DD/YY) :. <br />aTY IN5URANCE ` <br />PA~~ of ; ' <br />; <br />.. <br />- --n, v : <br />3-SEP-,999 <br />PRODUCER ,2476, THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Willis Corroon Corp. of Birmingham ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />800 Shades Creek Parkway HOLDER. THIS CERTIFlCATE DOES NOT AMEND, EXTEND OR <br />Suite 6000 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />PO Box 11587 (35202) COMPANIES AFFORDING COVERAGE <br />Birmingham AL 35209 <br />coMPANV National Union Fire Ins. Co. of Pittsburgh, PA <br />(205) 871-387, <br />Lisa J. Birchfield, CIC, CISR A __ <br /> _ <br />RiSURED COMPANY <br /> B <br />LORENCRO COAL COMPANY, LLC <br />C/O AL PERRY COMPANY <br />9203 PETERSBURG ROAD ~ C <br /> ~~ <br />EVANSVILLE IN 47711 cauPAN <br />r <br /> D <br /> <br />THIS IS 70 CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED, NOTWITHSTANDING ANV REQUIREMENT, TERM OR CONDIT ION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAV BE ISSUED OR MAV PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BV PAID CLAIMS. <br />EXCLUSIONS AND CONDITIONS O <br />F <br /> T <br />CO I <br />TYPE OF INSURANCE I POLICY NUMBER POLICY EFFECTIVE POLICY E%PIRATN)N DMnS <br />LTR DATE (MNIDDI'!`n DATE (MMIDDIY'!) <br />A GEN ERAL LIABRTP! GL5440348RA O,-.lUL-1998 01-NOV-1999 GENERAL AGGREGATE f 2.000, OOU <br /> X COMMERCIALGENEHAL LIABILITY PROOUCTSCOMP/OP AGO 1,000'000 <br />( <br /> CLAIMS MADE OCCUR PERSONALS AOV INJURY _ <br />f 1.000.000 <br /> OWNER'SA CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000 <br /> F~GAMAGE (An uneAm f 50. U00 <br /> MED EXP An one rson 5.000 <br /> AUT OMOBILE LIABILT' COMBINED SINGLE LIMIT f <br /> ANY AUTO <br /> _ <br /> ALLOWNED AUTOS BOO!LY INJURY f <br /> (Per person) <br /> SCHEDULED AUTQS <br /> <br /> HIRED AUTOS BODILY INJURY f <br /> NON-0WNED AUTOS 4Per arudent) <br /> <br /> PROPERTY DAMAGE <br /> $ <br /> GA RAGE LIABILTY AUTO ONLY-EA ACCIDENT $ <br /> <br /> ANV AUTO (OTHERTHAN AUTO ONLY: <br /> r <br /> EACH ACCIDENT f <br /> - <br />ADGREOATE <br /> E%CESS LIABILITY EACH OCCURRENCE $ <br /> <br /> UMBRELU FORM AGGREGATE $ __ <br /> <br /> OTHER THAN UMBRELU FORM <br /> WC STATU~ OTH~ <br /> WORKERS COMPENSATION AND jORV (MIT <br /> EMPLOYERS'LUBILITY EL EACH ACCIDENT $ __ <br /> THE PROPRIETOR/ <br />PAR <br />ER <br />lrIVE <br />E%EC <br />INCL <br />EL OISEASEPOLICY LIMIT <br />$ <br /> TN <br />S/ <br />l <br /> OFFlCERS PRE: E%CL EL DISEASE-EAEMPLOYEE <br /> OTHER <br />DESCRIPTION OF OPERATN/N3/LOCATONS/VEHICLES/SPECIAL RENB <br />RE: Permit No. C-96-084 Location: 2 miles West of Segundo, CO. on Highway 12 <br /> <br />::: <br />:CER7fFlCATE:HALDER .;~: .~~. ~.:~ ~ <br />iD dsy Salieellaf!on toi:rwnppy ~ : ~~ ~ ~ ~ ` <br />~CA.NCELLATION~ .. <br /> SHOULD ANY OF TXE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TXE <br /> E%PWATION GATE THEREOF, THE ISSUING COYPANY WILL >6tpdBLt~otpx>ta MAIL <br />COLORADO DIVISION OF MINERALS AND GEOLOGY 30 _ DAYS WRTREN NOTN:E TO THE CERTIFlCATE HOLDER NAMED TO TXE LEFT, <br />1313 $HERMAN STREET BIITI FANIDIE%1r%7YNN 61N7NNafOfiJf aNAk9BI )N7%aa%NN1RId%%Na %ILBa%ltifxX <br />ROOM 215 YN%xNNNN%TRNX %$$N(%ANNNTSfxDaX ~1<IBBI%% <br />DENVER CO 80203 AUTHOR ED PRESENTATNE <br />:ACORDZS-s~,95~~:~:::::::::.:~:~: ~:~.--::~;:::~:~:::Vpalausz~::.~~:;:~;: ,:.::'~~ ~:':::~~:.~~:::.r.:~.~:::~::..~~~.:;..:...~:..~-.. <br />.. ~ .:::.. ~:.: ~:,. ~. ~ `~~A ~RD CORPbRA'YION.~BBfi '.: <br />
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