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GENERAL51105
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Last modified
8/24/2016 8:37:31 PM
Creation date
11/23/2007 6:31:51 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981010
IBM Index Class Name
General Documents
Doc Date
8/11/1994
Doc Name
CERTIFICATE OF INSURANCE
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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THIS CERTIFICATE REPLACES THE ONE PREVIOUSLY SENT DATED 7/19/94. <br />AID111:11. III IIIIIIIIII~~I~II r OF INSURANCE 8/9/94DVY) <br />PRODUCER ggg THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />SEDGWICK JAMES OF TN INC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />P. 0. BOX 19810 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />KNOXVILLE, TN 37939-2810 COMPANIES AFFORDING COVERAGE <br /> COMPANY <br /> A FEDERAL INSURANCE CO <br />INSURED ~/(~ <br /> COMPANY Y C D <br /> B <br />WILLIAMS FORK COMPANY ETAL COMPANY <br />i 19 <br />P o Box lB7 c <br />94 <br />CRAIG CO 81626 COM <br />PANV ~I~~S'~~~OII <br /> D <br />L11nL,/d, <br /> y6 <br />COVERAGES l' <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 ANV REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH 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 <br />LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMBS <br /> DATE (MMIDDlYY) GATE (MNVODIYY) <br /> GEN ERAL LIABILT' GENERAL AGGREGATE E 2'+~OD sO~D <br />A X COMMERCIAL GENERAL LIABILITY PROOUCTS~COMP/OPAGG S Ls000~000 <br /> CLAIMS MADE OCCUR (95)37100018 7/20/94 7/20/95 pERSONALe ADV INJURY S L~OOOs000 <br /> OWNER'S 8 CONT PROT EACH OCCURRENCE S L , OOO f O~D <br /> FIRE DAMAGE (An one Lm S 100 s 000 <br /> MED EXP An one arson S 10~ODD <br /> AUT OMOBILE LIABILITY <br /> COMBINED SINGLE LIMIT S <br /> ANY AUTO <br /> ALL OWNED AUTOS <br />BODILY INJURY <br />E <br /> SCHEDULED AUTOS (Per person) <br /> HIRED AUTOS <br />BODILY INJURY <br />E <br /> NON~OWNED AUTOS (Par eccitlem) <br /> <br /> PROPERTY DAMAGE E <br /> GARAGE LIABILT' AUTOONLY-EA ACCIDENT $ <br /> ANY AUTO OTHER THAN AUTO ONLY <br /> EACH ACCIDENT $ <br /> AGGREGATE E <br /> EXCESS LIABILT' EACH OCCURRENCE $ <br /> UMBRELLA FORM AGGREGATE $ <br /> OTHER THAN UMBRELLA FORM $ <br /> WORKERS COMPENSATION AND STATUTORY LIMITS <br /> EMPLOYERS' LIABILITY <br /> EACH ACCIDENT E <br /> THE PROPRIETOR/ INCL DISEASE ~ POLICY LIMIT S <br /> PARTNERS/EXECUTIVE <br /> OFFICERS ARE: EXCL DISEASE EACH EMPLOYEE S <br /> OTHER <br />DESCRIPRON OF OPERATION$/LOGATIONS/VEHICLES5PECIAL ITEMS <br />THIS POLICY APPLIES TO TRAPPER MINING ING PERMIT liC-81-010 & INCLUDES COVERAGE FOR PROPERTY <br />DAMAGE 6 PERSONAL INJURY RESULTING FROM USE OF EXPLOSIVES. <br />CERTIFICATE HOLDER CANCELLATION <br />COLORADO DEPT OF NATURAL RESOURCES SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />DIVISION OF MINERALS 6 GEOLOGY EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL~1~ MAIL <br />ATTN KEN GORHAM lU DAYS WRITTEN NOTICE TO THE CERRFICATE HOLDER NAMED TO THE LEFT, <br />215 CENTENNIAL BUILDING BUT FAILURE TO MIHL-SUCkL NOTCE SHALL IMPOSE NO.OBLIGA oR+LIA9am <br />1313 SHERMAN ST OF ANY ND THE COMP NY, R5 AGEMS O EPRESEMATIVES. <br />DENVER CO 80203 rxoRlzeDR E ~~ <br />I <br />ACORD 25-5 (3/93) <br />-- O ACORD CORPORATION 1993 <br />Ir~ <br />
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