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GENERAL48439
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GENERAL48439
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Entry Properties
Last modified
8/24/2016 8:24:52 PM
Creation date
11/23/2007 4:19:52 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981011
IBM Index Class Name
General Documents
Doc Date
10/23/1995
Doc Name
CERTIFICATE OF INSURANCE
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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ACORD CERTIFICATE OF INSURANCE III IIIIIIIIIIIII III <br />o ~ <br />~o/9 <br /> 5 <br />z <br /> _ <br />999 <br />PRODUCER TIIIS CERlrnunlt 15 ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />S e d g w i c k James o f T N, I n c . ALTER THE COVERAGE AFFOMED BY THE POLICIES BELOM. <br />P. 0. Box 1 9 8 1 0 COMPANIES AF1=0RDING COVERAGE <br />Knoxville, TtJ 37939-2810 COMPANY <br /> A National Union Fire Ins. Co. <br />INSUFED COMPANY <br /> R <br />SUNLAND MINING CORPORATION COMPANY ~ - <br />249 East Main St. Suite 400 C /lF'T 00 ..,.. <br /> <br />Lex)ngton KY 4OSOJ ~ <br />COMPANY <br /> D <br />COVERAGES Division of Minerals ~ UeolDgv <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LIS TED BELOII HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED, NOTIJITHSTANDING ANY REQUIREMENT, TERM OR C ONDITION OF ANY CONTRACT OR OTHER DOCUMENT 411TH RESPECT TO NHICH THIS <br />CERT IF [GATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFOADEO BY THE POLICIES DESCRIBEIT HEREIN IS SUBJECT TO ALL THE TERMS, <br />_E%CLUSIONS ANO CCONDITIONS OF SUCH POLICIES. LIMITS S HONN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> <br /> TYPE OF INSURANCE POH(.Y NIIYBFA POLICY E}FE(:I1VE <br />~MIDD/Y>7 POIX,'Y EXPIMI/0N <br />~M~TYY) LIMnS <br />A GETY ERnL LlnnnTrY G L 5 4 1 7 5 6 8 R A 9/ 0 1/ 9 5 9/ 0 1/ 9 6 GENEPAL AGGREGATE § 2 0 0 0 0 0 0 <br /> % COMMERQAL GENERAL LIABILITY PRODUCTS~COMP/OP AGG § 1_N_C_L~LD E D <br /> CLAIMS ~ OCCUR <br />MAOF PERSONAL BADV INJURY E _O.0~0.0 <br /> OWNER'S 8 L'ONT PROT EACH OCCURRENCE § I D D D D D O <br /> FIRE DAMAGE lAny one Iirel § D D D D <br /> MED E%P IAny one person) § 5 D D D <br /> <br />A <br />Aur <br />DMDBIIE LVIBNTY <br />C A 5 4 1 7 5 6 9 R A <br />9/ 0 1/ 9 5 <br />9/ 0 1/ 9 6 _ <br /> % ANY AUTO COMBINED SWGLE LIMIT § l O O O O 0 O <br /> ALL OWNED AUTOS BODILY INJURY <br /> SCHEDULED AUTOS (Per person) E <br /> HIRED AUTOS <br />BODILY INJURY <br />E <br /> NON-OWNED AUTO IPer accidnetl <br /> 5 <br /> PROPERTY DAMAGE <br /> GARA <br />- GE LLIBRTIY <br />AUTO ONLY~EA ACCIDENT § <br /> ~ <br /> ANY AUTO OTHER THAN AUTO ONLY: E <br /> <br /> EACH ACCIDENT § <br /> AGGREGATE § <br />A Fxcfss uABILm 5 1 0 6 5 8 7 9/ 0 1/ 9 5 9/ 0 1/ 9 6 EACH OCCURRENCE X 0, 0 0 0, 0 0 0 <br /> UMBRELL4 FORM AGGREGATE ~ D, D D D, D D D <br /> OTHER THAN UMBRELLA FORM <br /> Nrt1Fim18M5 CIXAPENSAI%JN AMD _ <br />EMPLOYERSLIABIUIY <br />- _- <br />-- STAl Ui0RY71MRa' _ _ <br />- <br /> <br /> EACH ACCIDENT § <br /> THE PROPRIETOR/ <br />PARTNERS/ExECUfIVE INGL DISEASE-POLICY LIMIT <br />E <br /> OFFICERS ARE: EXCL <br />QIHEH DISEASE-EACH EMPLOYEE § <br />OESCRIPIION OF OPEHCIIONS/LOCATIONSNF]IILlESBPECNL nEIAS <br />AS RESPECTS THE APEX N0. 2 MINE, COLORADO PERMIT N0. C-81-O11 <br />CEFTTIFlCATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE OESxIi® POLICIES BE CNIC~ 9ETOIE THE <br />C O L O R A D O D I V I S I O N O F M I N E R A L S ExRRAT1oN DATE 1HETTEOF, THE IS4UMG COMPANY wILOEZ]im§vw:000MNL <br />AND GEOLOGY 3 0 DAYS wrarTEli NDrICE TO THE CETTIIFICHIE HOLOFTi NAMED TO THE LEFT <br />1 3 1 3 S N E R M A N S T. ROOM 2 1 5 X>KKE§aco§lE>oa>a~caxxwBE~A~4i<fA~iFX <br />DENVER C 0 8 0 2 0 3 . <br /> Y>K~n>o~vcaOX>t%~AMNi~4<3JALiI~ii~ <br />sX <br /> AUIF%lfaZFD~ <br />LJ ~^'~ <br />~~ .. <br />ACORD 25-5 3AxT 2 - 2 4 <br />_ _ @ACORD TION 1993 <br />
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