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GENERAL49067
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GENERAL49067
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Entry Properties
Last modified
8/24/2016 8:27:06 PM
Creation date
11/23/2007 4:49:57 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1982056
IBM Index Class Name
General Documents
Doc Date
3/29/1995
Doc Name
Certficate of Insurance
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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. ~ certificate of ~n~ura~nce <br />~~ r-. ~; Ei 1/FQ <br />To: State of Colorado Date: March 29, 1995 MAR 3 7 1995 <br />Address: Mined Land Reclamation Div. Re: ,~, <br />so„u;,. <br />1313 Sherman Street, Suite 215 ~~~I~tr, <br />Denver, CO 80203 Q 5 d GeU1Dgy <br />This is to certify that the policies designated below are in force on the date borne by Ihls Cenificate <br />NAME OF INSURED: CypI'l1S f1maX M1neIalS CtJmpanY eC a] <br />9100 East Mineral Circle <br />Address: Englewood, CO 80112 <br />TYPE OF INSVRANCE POLICY r POLICY PER100 POLICY LIMITSIYAWES <br />A) Commercial General Liability - 04/01/94 - $6,000,000 General Aggregate <br />Claims Made, Retro Date: 4/1/94 07/01!95 $6,000,000 Product(Completed Operations <br />a) All States GL3197I25 Aggregate <br />b) Texas GL3197127 $2,000,000 Personal turd Advertising Injury <br /> $2,000,000 Each Occurrence <br /> $2,000,000 Fire Damage (Any One Fire) <br /> $ 10,000 Medical Expense (Any One <br /> Person) <br />B) Auto Liability 04/01/94 - $2,000,000 CSL Eech Occurrence <br />a) All States CA1431816 07/01/95 <br />b) Texas CA1431819 <br />C) Workers' Compensation 09/01/94 - WC: Statutory <br />Employers' Liability 09/01/95 EL: $2,000,000 Each Accident <br />California Only C016120-02 $2,000,000 Disease -Policy Limit <br /> $2,000,000 Disease -Each Employee <br />D) Workers' Compensation 09/01/94 - WC: Statutory <br />Employers' Liability 09/O1/95 EL: $2,000,000 Each Accident <br />Other States C016] 19-02 $2,000,000 Disease -Policy Limit <br /> 5?..000.000 DinP,ac? - Poch Employer <br />E) Excess Workers' Compensation EX-335 09/01/94 - Company's Limit of Indemnity Each <br /> 09/01195 Occurrence: Statutory <br /> Self Insured Retention: $1,000,000 <br />This certificate of insurance neither affirmatively nor negatively amends, extends or alters the coverage afforded by those policy(les) <br />numbered above and issued by companies listed below. <br />Shoul ny of the above described policies be cancelled before the expiration date thereof, the issuing company will endeavor to mail <br />days written notice to the above named certificate holder, but failure to mail such notice shall impose no obligation or <br />liability of any kind upon the company, or upon this agency. <br />SEVERAL LIABILITY NOTICE (LSW 1001) 1~7 <br />The subscribing insurers' obligations under contracts of insurance to <br />which they subscribe are several and not joint and are limited solely <br />to the extent of their individual subscriptions. The subscribing <br />insurers are not responsible for the subscription of any co• <br />subscribing insurer who for any reason does not satisfy all or part of <br />its obligations. <br />2000 Bering Dr., Suite 900 <br />Houston, Tezas 77057 <br />P.O. Box 36429 <br />Houston, Texas 77236-6429 <br />Phone: 713783-6640 <br />Telecopier: 7131783-7241 <br />INSURANCE COMPANY(IES) ISSUING COVERAGE <br />A)B) National Union Fire ]assurance Company Pittsburgh PA <br />C)D)E) Old Republic Insurance Company <br />By <br />ra9..p.Cla <br />
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