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GENERAL49681
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GENERAL49681
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Entry Properties
Last modified
8/24/2016 8:29:14 PM
Creation date
11/23/2007 5:19:41 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1996084
IBM Index Class Name
General Documents
Doc Date
1/3/2000
Doc Name
CERTIFICATE OF INSURANCE
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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III ~II~II~II~~II ~~~ RECEIVED <br />9Q9 <br /> <br /> <br />CERTIFICATE QF iNBGRANCE ::..:..... :.: ".:: ',:..: .: <br />M'bf8'h~ .' .: ~ .::.. ~ ...~ '~:~ CeHlficate 4 <br />~~. <br />PRODUCER: DIYISIWI OT MI THIS CERTIFICATE IS ISSUED AS 4 MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE <br /> RTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE POLICY. THIB CERTIFICATE DOES NOT AMEND, <br />Marsh USA InC E%TEND OR ALTER THE COVERAGE AFFORDED BY THE POLICES LISTED BELOW. <br />P. U. Bex t9d10 COMPANIES AFFORDING COVERAGE <br />Knoxvlllz. TN 3 793 9-281 0 COMPANY <br /> A <br />865~SB4~9101 ZURICH AMERICAN INSURANCE COMPANY <br />LETTER <br />INSURED: COMPANY <br /> B <br /> LE TTEH <br />LORENCITO COAL COMPANY, LLC COMPANY <br /> <br />cio AL PERRY C <br />LETTER <br />9203 PETERSBURG ROAD COMPANY <br /> D <br />EVANSVILLE, IN 47711 LETTER <br />CtlVERAGES:~: :.:.. .......... ............::.... <br />THIS IS TO CERTIFY THAT 7HE POLICIES OF INSURANCE LISTED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. <br />NOTWITHSTANDING ANV REQUIREMENT, TERM OR CONDRION OF ANY CONTRACT OR OTHER DOCUMENT WRH RESPECT TO WHICH THE CERTIFICATE MAV BE ISSUED OR MA <br />PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES LSTED HEREIN IS SUBJECT TO 4LL THE TERMS, CONDITIONS 4ND EXCLVSIONS OF SUCH POLICIES, LIMITS SHOWN <br />MAV HAVE BEEN REDUCED BV PAID CLAIMS. <br />CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY E%PIRATION LIMITS <br />LTR DATE MM/D0 DATE MMrDD~ <br />A GE NERAL LIABILITY GL09258J1J~00 1/Ot/00 1/Dt/D1 GENERAL AGGREGATE $ 2000,000 <br /> X CCMMEROiAL GENERAL UABILiTV PRODUCTS-COMPrOP AGG $ 1,000,000 <br /> CLAIMS MADE ~ULCUR PERSONAL 8 ADV INJURY $ 1,000,000 <br /> O WNER'S CONTRgCTOR'S PgOT EALM OCCURRENCE $ 1,000.000 <br /> FIRE DAMAGE An one fin $ 50,000 <br /> MED EXP An one rson $ 5,000 <br /> AU TOMOBILE LIABILITY <br /> COMBINED SINGLE LIMB $ <br /> ANY FUTO <br /> ALL OWNED AUTOS BODILY INJURY <br /> § <br /> SCHEDULED AUTOS Par rson <br /> w RED AUTOS BODILY INJURY § <br /> NON-0WNED AUTOS Per occident <br /> PROPERTY DAMAGE § <br /> GA RAGE LIABILITY AUTOONLV-EA ACCIDENT $ <br /> AM' AUTO OTHER THAN AUTO ONLY: <br /> EACH ACCIDENT $ <br /> 4GGREGATE $ <br /> EX CESS LIABILITY <br /> EACH OCCURRENCE $ - <br /> UMpRELLAFORM <br /> OTHER THAN UMBRELLA FORM 4GGREGATE $ <br /> WORKMAN'S COMPENSATION STATUTORY LIMBS <br />~ <br />L AND EMPLOYERS LIABILITY EACH acc1DENT $ <br /> rHE PROPPiETOR, <br />Ppgr NFRS: <br />xEC <br />rm INCI <br />DISEASE ~ POLICY LIMB <br />$ <br /> U <br />E <br />E <br /> OFr-icERS pRE EXCL DISEASE-EA EMPLOYEE $ <br />( OTHER <br />DESCRIPTION OF OPERATIONS !LOCATIONS /VEHICLES! SPECIAL ITEMS <br />RE PERMIT aC-96~08a. LOCATION. 2 MILES WEST OF SEGUNDO. COON HIGHWAY 12 <br />$5,000 -- PROPERTY DAMAGE DEDUCTIBLE IS APPLICABLE <br />CERTIFICATE M4LDEA .;;.~' :.:. ~:~~. ~~::': ~'~:: ~'~~::. ~'::..'..'.:.:::. ~'~ '.: ~ ':'~ : CANCEUATION :.~::.: ':'.'~ . <br /> BHO~LD pnv CF rHE PCLPES U5rE01+EREIN BE CpNCELEC BEFORE THE E%PiRATION <br /> DpTE'HEPCCr .~ ~ ~nISUPER AFFCPD~NG : CVERnGE W",.l {IFjMp <br />!~• <br /> <br />COLORADO DIVISION OF MINERALS AND GEOLOGY ~ <br />y~y{,~~ <br />30 opus WRIrrEN NOr~cE ro rHE CERriFicprE HOLDER Npn+ED HEREIN YL^°f"i"F <br />7313 SHERMAN STREET y~~.~y~ry~.,,1~t;~~~,~~„~~I~y~~. <br />DENVER. CO 80203 ~>~~,~.yr~gf <br /> MARSH USA, INC. <br /> By ~ <br /> 'EdMI ~ ':V LID AS'dF:.'. ::. ..: :. ~~.. ::.~.. :: ....:~ ~ ~ ~: '12130x98 ~: .:: ~:.:.:...: <br />
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