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GENERAL48835
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GENERAL48835
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Last modified
8/24/2016 8:26:04 PM
Creation date
11/23/2007 4:35:57 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1980003
IBM Index Class Name
General Documents
Doc Date
6/3/1991
Doc Name
CERTIFICATE OF INSURANCE
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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~` - G <br />CERTIFICATE fJF IN SURANCE: ,~ I~.f 91SSDE OATE,MM/OD/YY) <br />:::.::::.::.:...::..:.::..:.::::::::..::::.::::..::.::..:..:..:.:.:::.............. ....................:............ WI:P:;:.::: 7/29/91 <br />PRODUCER <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS <br />NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. <br />Marsh 8 McLennan Incorporated EXTEND OR ALTER THE COVERAGE AFFORDED 0Y THE POLICIES BELOW. <br /> <br />1166 Avenue of the Americas COMPANIES AFFORDING COVERAGE <br />New York <br />NY 10036-2774 <br />, <br /> COMPANY A <br /> LETTER CONTINENTAL CASUALTY CO <br /> COMPANY B <br />INSURED IErTER TRANSPORTATION ZNSIIRANCE CO <br /> <br />W R GRACE 6 CO <br /> COMPANr <br />C <br />1114 AVENIIE OF THE AMERICAS LETTER <br /> <br />NEW YORK, NY 10036 <br /> COMPANY D <br /> LETTER <br /> COMPAM' E <br /> LETTER <br />R, : - <br />^OttE Ass::':?<"::' :::::::::::::~:::;::::;:::;;::.:.:::•::::-:<~::;:::::::::,::•::::::--<;::s:<:: <br />::;:<.:::.;:::::::::;:.:::::::::::::;::::::::::::::.;::.;:•;_.:.::::.:::::;;:::;::::;.:>:::.::;.;:.:::<.::<::::::::::::::.::::<:::,•::;:::::.;;:;•:•r:>;,:::: <br />THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW H AVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. <br />NOTWITHSTPNDINGRNY REQUIREMENT, TERM OR CONDITION OF AN Y CONTMCT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY <br />BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BV THE POL ICIES DESCRIBED HEFlEIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDI- <br />TIONS OF SUCH POLICIES. <br />~ TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTNE POLICY EXPIRATION LNBILRY UMRS N THOUSANDS <br />lTR WTE (MM/DD/YYI PATE (MM/DO/YY) EACH AGCiFiECa4TE <br />A °E NER"LI'"~TY CCP001604364 6/30/91 6/30/92 BODILY <br /> 1( COMPREHENSNE FORM INURY E <br /> X PREMISES/OPERATIONS PROPERTY <br /> <br />R UNDERGROUND <br />DAMAGE <br />S <br />S <br /> E%PLOSION 6 CIXIMSE HAZARD <br /> x PRODUCTS/COMPLETED OKRAlldB <br /> 1( CONTRACTUAL COMBINED `S 1000 E 1000 <br /> ][ INDEPENDEN7 CONTRACTORS <br /> ~( BROAD FORM PROPERTY DAMAGE <br /> X PERSONAL INJURY PERSONAL INJURY S 1000 <br />A Au raMOBILELUBILTr CCP001604364 6/30/91 6/30/92 eoDUv <br />D <br />v <br /> R ANY auro pm <br />rtns <br />orat E <br /> ALL OWNED AUTOS (PRN. PASS.) BODILY <br /> ALL OWNED AUTOS OTHER THAN <br />PRIV. PASS. ~ INJURY <br />AOLI E <br /> HIRED AUf03 PROPERTY <br /> NON-OWNED AUTOS DAMAGE E <br /> GARAGE LWBILffY BI 8 PD <br /> _ COMBINE $ 100 ~~ <br /> FXCE88 UABIITY <br /> UMBRELLA FORM BI 8 PD <br />COMBINED <br />E <br />E <br /> OTHER THAN UMBRDIA FORM <br /> <br />E <br /> <br />WORKERS' COG@pISAT10N <br />WC 507415909 <br />6/30/91 <br />6/30/92 . . <br />STATUTORY <br />..... . . . .. .. ...... ... <br /> <br />. ........ .. ... ... <br />B AND WC 907415910 6/30/91 6/30/92 '.: zaaaIEADH~~T+TI <br /> BAwLOYERS• uAeuTr soodDlsFASE-FOUL uMrtl <br /> <br /> zaadDlsEnsE~EACH EMR-DVEFI <br /> OTHER <br />DESCRIPTION OF OPERATIONS/LOGTIONS/VEHIClE3/SPECNL ITEMS <br />c~nflcATeHO~D :;:::;:::• :::::::::::::::<:;:::;:.:::::::::::::.;::::.:::::;:::::::::;:;;:;:::;.:;::::, cawceLU~noK:::;;::::::•:::::::...::..,:;::.::.::.;:. ;::.:.;:..:;..::.::::::;:.::::;::::::.:::::::;:;::::;;::::::-::;::;..,:;.: :: <br /> SHOULD ANV OF THE ABOVE DESCRIBED POLICIES BE CPNCELLED BEFORE THE FX- <br />Mined LeIId RBC18 imet loII PIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO <br />Dl V 1610a MAIL] 0 DAYS WRITTEN NOTICE TO THE CERTIFICJITE MOLDER NAMED TO THE <br />1313 8hermaa Street ~FT• BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY <br /> OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. <br />215 Ceatenaial Buildiag ::<;: AUrHOR REPRESENTATNE <br />Deaver, CO 80203 <br />;: <br />; ~~ <br /> <br />~/ <br />: <br />pAGp::::::: :Oi::::::':::::::;':'::::%:::;:?:':;':;:;:`:< ::::::::::.:::::: ®ilp-ACOpDCOHtTORAriON 7§a4::: <br /> <br />
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