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GENERAL48915
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GENERAL48915
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Entry Properties
Last modified
8/24/2016 8:26:35 PM
Creation date
11/23/2007 4:41:50 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1980006
IBM Index Class Name
General Documents
Doc Date
9/29/1995
Doc Name
Certificate of Insurance
From
KERR COAL CO
To
OSM
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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a~;~~~~~. CERTIFICATE OF INSURANCE °g~ 5 9 <br />PRODUCER THIS CERTIFlCATE IS ISSUED AS A MATTER OF INFORMATION ONLY ~. <br />Van G i Lder Ins urarlce Corp AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />700 Hr°aL3way+ Suite 1000 CERTIFlCATE DOES NOT AMEND. EXTEND OR ALTER THE <br />_COVJ^'RAGE AFFORDED BY THE POLICIES BELOW. <br />Denve+ , CO 8020 COMPANIES AFFORDING COVERAGE <br />FR COMPANY <br />303-837-BSOG A St . F'a LL I. F i rP b i•1a+- i ne <br />INSURED COMPANY <br />Wagner E•~uiF+ment Co. B <br />F.O. HDx 17626 coLlweY <br />I+enver CO 80217-0620 C <br />COMPANY <br />D <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 ANY REOUIREh1ENT, TERM OR CONDITION OF ANV CONTRACT OR OTHER DOCUMEM Wfl}i RESPECT TO WHICH THIS <br />CERTIFICATE MAV BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />CO rypE OF INSURANCE PODCY NUMBER POLICY EFFECTNE POLICY EXPMLATION LIMI TS <br />LTA DATE IMY/DNYY( GATE (MMND/+'1') <br />~ GENERAL LIABILRY GENEMLAGGREGATE f ~.000.QQ(i <br />~ H X COMMERCIAL GENERAL DABIDTY o021•lH2631 lU/OlI9S' SGIOt /9fT PRODUCTSLgAP/OP AGG f j. Q(~Q.000 <br /> CLAIMS MADE ~ OCCUR ~ PERSONAL d ADV INJURY f 1 ! Q(10 * O(1(3 <br /> OWNER'Sd CONT PROT EACH OCC:RRENCE f 1..OOO, OOO <br /> FIRE DAMAGE IArry ane hre) If Sn,00G <br /> MED E%P IMy ore person) ; f .~~ . QQO <br /> AUTOMOBILE LABILfIY I <br />' COMBINED SNGIE DMIT f <br />,, A X aNYAUTO 602NHP631 10/01/95 1Gi07.!Qi± I .L-000.006 <br />. ALL OWNED AUTOS BODILY INAIRY <br />I SCHEDULED AUTOS (Per Persm, , f <br /> HIRED AUTOS <br />BODILY INJURY <br /> <br />~( NON-0VMED AUTOS <br />(PerAm~s'i f <br /> <br />i - PROPERTY DAMAGE f <br />t <br />GARAGE LABILITY <br />AUTO ONLY ~ EAACCIDENT <br />I f <br />I ANY AUTO OTHER THAN AUTO ONLY: I <br />~ EACH ACCIDENT i f <br /> AGGREGATE !f <br /> EXCESS LIABBJTY EACH OCC::RRENCE , f <br /> UMBRELLA FORM AGGREGATE ,f <br /> OTHER THAN UMBRELLA FORM ' f <br /> WORKERS COMPENSATION AND !X STATLRIXiY LIMRS I <br /> EMPLOYERS'LIABILRY <br />A WVAU2UU985 10/01/95 10/01 /9.4 EACH ACOIOEYT if 'I (~n.(1Q(i <br />. IH THE PROPRIETOR/ INCL WVAO20OS'85 lU/01/95 10/OT /96 DISEASE -'CUCY UNIT f SQQ. QOQ <br />I PARTNERS4%ECUOVE - <br /> OFFICERSARE: E%OL DISEASE ~ RICH EMPLOYEE ~ f 1 AO.000 <br />OTHER <br />DESCRIPnON OF OPERAnONSILOCAnONSNEHICLES5PECAL REMS <br />CERTIFlCATE HOLDER CANCELLATION <br />i~err Cual Cumpany <br />Attn: GeuT-ye F~ t1eL-son <br />F.0. H°r. 487 <br />Walden, CuLDraLly 80480 <br />ACORD 25•S (3/93) <br />SNOULO ANY OF THE ABOVE OESCRIBEO POLICIES BE CANCELLED BEFORE THE <br />E%PIRATION GATE THEREOF. THE ISSUING COYPANY WILLJEOID~BQO(MAIL <br />3O DAYS WRRTEN NOTICE TO THE CERnFICATE HOLDER NAMED TO THE LEFT <br />Bcm m:ssva~~c <br />J~ ~~ rtst +193A3000v <br />~ ACORD CORPORATION 1993 <br />
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