Laserfiche WebLink
~eT^ Q _ i'~yY^M-9 ~~.-..~, '~yy ..a_r _0~~ III IIIIIIIII'lll III Lti. ~:''•~•x e. .,~~ <br />®~ - ISSUE DATE (MM/DD/Y1~ <br />"u,'. <br />® ® ~ ~ sss 9/11/87 as <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS <br />Adco General Corporation NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NO7 AMEND, <br />EO BOX 4005 E%TEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Denver, CO 80204 COMPANIES AFFORDING COVERAGE <br />The Neill Agency (Broker) <br />Box 128 303-872-3175 COMPANY <br />LETTER A <br />Admiral Insurance Co <br /> . <br />Hotchkiss, CO 81419 COMPANY <br />INSURED LETTER B <br />Western Slope Carbon, lnc• LETTERNY C <br /> <br />6165 Hwy 133 <br />Somerset, CO 81434 COMPANY <br />LETTER <br /> COMPANY <br />LETTER <br />THIS IS 70 CERTIFY THAT POLICIES OFINSURANCE LISTED BELOW HAVE BEEN ISSUEDTO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY <br />BE ISSUED OR HAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT 70 ALL THE TERMS, E%CLUSIONS, AND CONDI- <br />TIONS OF SUCH POLICIES. <br />CO <br />TYPE OF INSURANCE <br />POLICY NUMBER POLICY EFFECTIVE PoUCY E%PIPATION LIABILITY LIMITS IN THOUSANDS <br />iLTR pA1E IMMNDM') DATE (MMlppfrVl EACR <br />AGGREGATE <br /> OCCURRENCE <br /> GE NERAL LIABILITY BODILY <br />A X COMPREHENSIVE FORM Iwuar $ $ <br />'~ X PREMISES/OPERATIONS 9/13/87 9/13/88 PROPERTY <br /> UNDERGROUND A87EG14024 DAMAGE $ $ <br /> IXPLOSION d COLLAPSE HAZARD <br /> PRODUC7SlCOMPLETED OPERATIONS <br /> CONTRACTUAL <br />COMB NED <br />`$ rjOD <br />`$ rj 00 <br /> INDEPENDENT CONTRACTORS <br /> RROAD FORM PROPERTY DAMAGE <br /> PERSONAL INJURY PERSONAL INJURY $ <br /> A UTOMOBILE LIABILITY <br />ANY AUTO ~ ~ ~ ~ ~ ~ ® BODAr <br />IP~EB ff~v'4 <br />$ <br /> ALL OWNED AUi05 (PRIN. PASS I BOp;Lr <br /> ALL OWNED AUTOS ~ PRHV RPASASN~ S t P 11198 IRR IrXAJENR $ <br /> <br /> HIRED AUTOS PROPERTv <br /> NON-OWNED AUTOS MINED L.AN DAMAGE $ <br /> GARAGE LIABILITY FCLAMAT!ON DI <br />P ISION BI b PD <br /> . COMBINED $ <br /> E%CESS LIABILITY <br /> UMBRELLA FORM BI b PD <br />$ <br />$ <br /> COMBINED <br /> OTHER THAN UMBRELLA FORM <br /> ' STATUTORY <br /> WORKERS <br />COMPENSATION $ (EACH ACCIDENT) <br /> AND <br />' $ (DISEASE~POLICY LIMIn , <br /> EMPLOYERS <br />LIABILITY $ (DISEASE-EACH EMPLOYEEI <br /> OTHER <br />DE SCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS <br />Underground Coal Mine (Hawks Next) $1,000 ded per claim incl Loss Adjustment Expense <br />Exclude claims by subcontractors, Blacklung <br />State of Colorado <br />Division of Mined Land Reclamation <br />1313 Sherman St., Room 423 <br />Attn: Susan Mowry <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE E%• <br />PIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR 70 <br />MAIL lO DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED 70 THE <br />LEFT, BUT FALLURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY <br />OF ANY KIND UPON THE COMPANV~I7S AGENTS 1TR REPRESENTAVIVES. <br />ITHORIZED REPRESENTATIVE !' - /" ' <br />