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GENERAL47600
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GENERAL47600
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Entry Properties
Last modified
8/24/2016 8:22:48 PM
Creation date
11/23/2007 3:38:31 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1980007
IBM Index Class Name
General Documents
Doc Date
12/11/1995
Doc Name
CERTIVICATE OF INSURANCE
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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; ER"f~FICAT~ - ' II IIIIIIIIIIIII I UATE;GII/DDM7 <br />A1~4ii:i1 <br />C QF INSURANCE <br />. .. <br />999 .:..:..:..:..: ::.: .: <br />PRODUCER THIS CERTIrn.wle I, I~~utu AS A MATTER OF INFORMATION <br />Johnson 8 Higgins of California ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Casualty Departrnent HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />2029 Century Park East ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Los Angeles, CA 90067 COMPANIES AFFORDING COVERAGE <br />Tel: (310) 551667 <br /> COMPANv <br />0659A-GL2 A INDEMNITY INSURANCE COMPANY OF NORTH AMERICA <br />INSURED <br />ATLANTIC RICHFIELD COMPANY, ITS COMPANY <br />B <br />SUBSIDIARIES AND SUBSIDIARIES . <br />THEREOF AS NOW OR HEREINAFTER COMPANY <br />CONSTITUTED C <br />515 SOUTH FLOWER STREET <br /> <br />LOS ANGELES, CALIFORNIA 90071 COMPANY <br />p <br />..~ .:............::..:..::..::..::..:..:.s:.:::.:::.:::~::::~:: ~~ ~~:~:;..::.;:...:~::..::.;..~.::.::.~ ~:~ ~.,..,:..::..::.::;.:.,:::.:;.:;..:~.:;.:;..::. <br />4YERAG~$ ,:: :~ ~::~...:..:..:..~..:.::.:..............::::.:,:::..:,.:..:.:..:...~..:..:..:..:.......:.:::...:.::...:.:.::..~..:.. <br />THIS IS TO 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 CONDITION OF ANV CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCL'JGiONS ANG CONDITIONS OF SUCH POLICIES. LIMBS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />CO <br />LTR rypE OF INSURANCE POl1CY NUMBER POOCY EFFECTIVE POLICY E%PIMTION LIMITS <br /> DATE (MN/DDM1 DATE (YM/OD/YY) <br />A OE NEMLLIABILITY ISL G1423156-0 01-01-96 01-01-99 BODILY INJURY OCC f N/A <br /> X COMPREHENSIVE FORM BODILY INJURY AGG E N/A <br /> X PREMISES/OPERATIONS PROPERTY DAMAGE OCC 5 N/A <br /> X UE7N(PLEfEION 8 COLLAPSE HAZARD PROPERTY DAMAGE AGG s NIA <br /> X PRODUCTS/COMPLETED OPER BI B PD COMBINED OCC 5 2,000,000 <br /> X CONTRACTUAL B18 PD COMBINED AGG 5 2,000,000 <br /> X INDEPENDENT CONTRACTORS PEFSONALINJURYAGG a ~ NIA <br /> X BROAD FORM PROPERTY DAMAGE <br /> X PERSONAL INJURY <br /> AUT OMOBILE LIABILITY <br />BODILY INJURY <br /> <br />ANY AUTO <br />(Per person) S <br /> ALL OWNED AUTOS (Prlvete Peas) <br /> ALL OWNED AUTOS BODILY INJURY <br />(Par accltlenn S <br /> (OIAer thin Private Passenger) <br /> <br /> HIRED AUTOS <br /> PROPERTY DAMAGE f <br /> NON-0WNED AUTOS <br /> GAMGE LIABILITY BODILY INJURY 8 <br /> PROPERTY DAMAGE S <br /> COMBINED <br /> EXC ESS LIABIl1TY EACH OCCURRENCE S <br /> UMBRELLA FORM AGGREGATE S <br /> . -0THER THAN UMBRELLA FORM- - - - - ~ - - '- S <br /> WORKERS COMPENSAnOM AMD ~ <br />~ $TATUTORV UNITS ~ ' <br /> EMPLOYERS' LIABNTY ~ ~ <br />~~~ <br /> ~~ EACH ACCIDENT S <br /> THE PROPRIETOR/ <br />PARTNERS/E%EGU7IVE INCL DISEASE-POLICY LIMIT S <br /> <br /> OFFICERS ARE: IXCL DISEASE-EACH EMPLOYEE 5 <br /> OTHER DIYIBIDn 0 <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLESAPECIAL ITEMS (LIMITS MAY WIVE BEEN REDUCED BY PAID QAIMS AND MAY HAVE DEDUCTIBLES OR RETENTIONS) <br />*PRODUCTS COMPLETED OPERATIONS. <br />NAMED INSURED INCLUDES MOUNTAIN COAL COMPANY, WEST ELK MINE, PERMIT NO. C-80-007. <br />C RTtFI.... :H ~ .......:..... ...:~ ::::..:......:.::.....:...~..~..~..~..:.:....:.......:...... <br /> SHOUlO ANY OF THE ABOVE DESCRIBED POl1C1ES BE CANCELLED BEFORE THE <br />COLORADO DIVISION OF MINERALS AND <br />GEOLOGAY, OFFICE OF LAND RECLAMATION EIfPIMnON DATE THEREOF, THE ISSUIMO COMPANY WILL ENDEAVOR TO MAIL <br />ROOM #215, CENTENNIAL BUILDING 10 GAYS WRITTEN NOTCE TO THE CERTIFICATE NO NAMED TO n1E LEFT, <br />1313 SHERMAN STREET BUT FAILURE TO MAIL SUCH NOTICE SHA POSE O BIIOATION OR LIABILITY <br />DENVER <br />COLORADO 80203 <br />, OF ANY KIND UPON THE CO ANY TS OR REPRESENTATIVES. <br />ATTENTION: DAVID BERRY <br /> AUTHORISED REPRESENTATIVE a <br /> <br />.. .. ~ ... ..... ........... .. ....... .. .. .. .......... .......... .... ................ .. .. ..... ....... ......~.. .. .. .... C. ....: :.::..,......:. .. ....~.:. .:.. ~19B3.J <br />
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