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GENERAL48989
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GENERAL48989
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Entry Properties
Last modified
8/24/2016 8:26:51 PM
Creation date
11/23/2007 4:46:31 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1992081
IBM Index Class Name
General Documents
Doc Date
3/31/1997
Doc Name
Certificate of Insurance
From
PEABODY
To
DMG
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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.. -r. ~. <br /> <br />ACORD (V1@Lf~®h~M~O '~Ir ~ : ~ ~ `~' 1 i v \7 V - ~' FV ` DATE IYYmom7 <br /> 19-Mar-9r. <br />PRODUCER THIS CERTIFICATE IS 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 />SEDGWICK JAMES OF NJ , INC. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />3 BECKER FARM ROAD COMPANIES AFFORDING COVERAGE <br />ROSELAND, NJ 07068 COMPANY <br />G-44 A INDEMNITY INS.CO. OF N. AMERICA <br />INSURED COMPANY <br />B €I <br /> <br />HAYDEN GULCH TERMINAL COMPANY '~ <br />P.O. BOX 882323 ~ <br />STEAMBOAT SPRINGS, CO 80488 COMPANY <br /> D <br />~y ~i <br />CD G S :y Mb • „ eg r,{th 'd.^7rvh Yom' iF. 't"9& .^fte 'i~~ %S'f n~i'' .. .''~,i. ' <br />~ <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN <br />ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY 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 MAV HAVE BEEN REDUCED BY PAID CLAIMS. <br />CO <br />LTR <br />TYPE OF INSURANCE <br />POLICY NUYBER POLICY EFFECTIVE <br />DATE INN/OD/YY) POLICY E%PIRA710N <br />DATE (YY%DO/Y1') i <br />LIYITS <br />A GE NERAL LIABILITY GENERAL AGGREGATE f 3 OOO OOO <br /> COMMERCIALGENERALLIABIUTY HDO G1 896537-9 10/01/96 10/1/97 PROOUCrs.coMPIOPACC f 2 000,000 <br /> CUIMS MADE OCCUR PEFSONAL6ADV INJURY f 1 OOO OOO <br /> OWNER58CONTRACTOR'S PROT EACH OCCURRENCE f 1 GOO, OOO <br /> BROAD FORM VEN ORS COVERAGE INCLU ED FIRE DAMAGE(AryorwMC) f 50 000 <br /> MEO EXP (Any ons person) S 5 OOO <br /> AUT OMOBILE LIABILITY <br />A ANYAUTO ISA HO 712926-9 10/01/96 10/1/97 COMBINED SINGLEUMIT s1,000,000 <br /> ALL OWNED AUTOS <br />BODILY INJURY <br />f <br /> SCHEDULED AUTOS (Per person) ' <br /> HIRED AUTOS <br />Dl <br />PO <br />L <br />y <br />ltlm9 Y <br />f <br /> NON-OWNED AUTOS <br />ir <br />( <br />i <br />c <br />c <br /> <br /> PROPERTY DAMAGE f <br /> GARAGE LIABILITY AUTO ONLY~EA ACGDENT f <br /> ANY AUTO OTHER THAN AUTO ONLY: s _; d'.; `. <br /> EACH ACGDENT f <br /> AGGREGATE f <br /> E%CESS LIABILITY EACH OCCURRENCE S <br /> UMBRELU FORM AGOREGATE~ S <br /> OTHER THAN UMBRELU FORM S <br /> WORKERS COMPENSATION AND T R U ITS ER ~• <br /> EMPLOYERS' LIABILITY <br />EL EACH ACCIDENT <br />f <br /> THE PROPRIETOFV <br />PARTNERS/E%ECUTIVE INCL EL DISEASE ~ POLICY OMIT f <br /> OFFICERS ARE: E%CL EL OISEISE-EA EMPLOYEE S <br /> OTHER <br />DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLEf/SPECIAL ITEMS COVERS OPERATION <br />FACILITY INCLUDING DAMAGE FROM SURFACE COAL MINE OPERATIONS, THE USE OF <br />EXPLOSIVES AND DAMAGE TO WATER WELLS. APPLICABLE TO CDMG PERMIT N0. C-92-081. <br />CEp,TIF C TE; O,L R'<P ~ • ".u.. ~., ' "' . <br />LL C'ANCELLAT,ION ~. - _ x ., . <br />OO DEPT OF NATURAL RESOURCES SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />DIV OF MINERAL 8 GEOLOGY EXPIiIATION DATE THEREOF, THE LSSUINO COYPANY WILL XLXa(FX~6YI~i4 YAIL <br />1 31 3 SH ERMAN , ROOM 21 5 3O DAYS WRITTEN NOTICE i0 THE CERTIFICATE HOLDER NAYEO TO THE LEFT, <br />DENVER, CO 80203 - 2273 ~,r,~X~x~,IC~I{C,~><,Ir„~~c,~X,~~„~yGYJ61~DU6tlic'x <br /> ifd(XTXJ(Y~AfrN,xXidiJt7tlYdcx~].SIYJA11~(xJHCx.14iwHCxdkc;R~IIt~lifJt;]Lx <br /> AUTHORIZED REPRESENTATIVE , / <br />"' 'a.bn...Q..s <br />CO D'~~S `9r) "-° <br />"' a.. # "ax ~e>t r ~ <br />r . I, ®'`~A~CO ~ C'0.,.. O f/~T O 88 <br />s <br />xt n <br />y ~ i cERrss_I <br />
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