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GENERAL53043
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GENERAL53043
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Entry Properties
Last modified
8/24/2016 8:38:43 PM
Creation date
11/23/2007 8:16:31 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1984062
IBM Index Class Name
General Documents
Doc Name
CERTIFICATE OF INSURANCE
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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_ _ ..... .. - iii iiiiiiiiiiiiiiii .. <br />AI>111:1/. <br />PROpUCER <br />SEDGWICK JAMES OF TN, INC. <br />P. 0. eox 19810 <br />KNOXVILLE,TN 37939 <br />(615)584-9101 <br />CODE tYFCOOE <br />MUiYRED <br />CYPRUS MINERALS CD. <br />AND ITS SUBSIDIARY CO. <br />P. 0. HOX 3299 <br />ENGLEWOOD,CO 80155 <br />IV~ ~~ ~~~/' RBUC~GT/ P~// 7Q~ <br /> 999 ~Z__ __. - ___. ___ <br />THIS CERTIFICATE IS ISSUED AS A MATTER OFF INFORMAAATION ONLY AND CONFERS <br />NO RIGHTS UPON THE CERTIFICATE MOLDER. THIS CERTIFICATE DOES NOT AMEND. <br />i E7(TEND OR ALTER THE COVERAGE AFFORDED BV THE POLICIES BELOW <br /> COMPANIES AFFORDING COVERAGE <br />COMPANY A : NATIONAL UNION FIRE INS. CO. <br />LETTER A <br /> <br />NY ee D <br />__-H: ____ ._.__.____~ ~ ~ ~ ~ <br />f,-~_-_ <br />CC <br />B <br />ETTER C <br />L <br />CoMPANV ~ -._...._ _ <br />C: _____ _. JUL__. r' .I~~J <br />LETTER <br />COMPANY <br />D D: MINED :.:11 N.. <br />LERER ,:"••^.1 4MGTIf)kl -TI1/!'•' <br />COMPANY E : <br />LETTER E <br />~.6~~~SQF-'S. _.~.. Z_. .rm. ra'wy-JS1WY m+.; _ ~ _- _ ..-.. .. _SY.. ..... _ -~ _ _ _ - `~L~. <br />Sl•k-~ ~ T~T"~r~~'LLS"-•"•. •: =Y+atYaiW ~----.. <br />THIS IS 70 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 ANV CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THI$ <br />CERTIFICATE MAV BE ISSUED OR MAV PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDRIONS OF SUCH POLICIES. LIMITS SHOWN MAV HAVE BEEN REDUCED BY PAID CLAIMS <br />CO TYPE OF INSURANCE POLICY MUYlER 'POLICY EFFECTIVE POLICY ES-IRATION ~ ALL LIMITS IN THOUSANDS <br />.TR DATE IMMIDDIYYI DATE IMM/DDIYYI <br />OEHlRAL LIABILRY ' <br />~,'! COMMERCIAL GENERAL LIABILRY '. ' <br />['M LlAIMS MADE :OCCUR.! <br />L __ <br />A CPJWNES•sacoNTRACroR•smor.; RMGLCMc^^498446 <br />X: PRODUCT/VENDOR <br />X XCU <br />AUTOMOBILE LIAlILRY <br />AA1NY AUTO <br />i ALL OWNED AUTOS <br />A SCHEDULED AUTOS <br />HIRED Alff05 <br />NON-0WNED AUTOS <br />~. GARAOE LIABILRY <br />RMCA562943E <br />EXCESS LIABILITI' <br />'OTHER THAN UMBRELLA FORM <br />' WORKER'S COMPENSATION <br />AMD <br />EMPLOYERS' DABILRY <br /> GENERAL AGGREGATE t 4000 <br /> PRODULTS~COMP/OPS AGGREGATE' 3 2000 <br />. PERSONAL L ADVERTISING INJURY 3 2000 <br />Q7/Q1/90 07/Q1 /9 }ALB OCCURRENCE S 2000 <br /> FIRE DAMAGE IAny one (rte) . 3 2000 <br /> MEDICAL EXPENSE IAny ene wnonl ~ 3 Q <br /> COMBINED <br /> LE 3 <br /> 1 QQQ <br />LIMR . <br /> BODILY <br />Q7/01/90 S Q <br />r/ <br />Q7/Q1 /9~P <br /> wnonl <br />e <br /> BODILY <br /> INJURY S <br /> IP1! ecnaentl Q <br />-- <br /> PROPERTY S ~ <br /> DAMAGE Q <br /> --~-~ ~~---~EALN-~~~ ----- AGGREGATE <br /> OCCURRENCE <br />/ / / / ' S S <br /> Q Q <br />. STATUTORY <br />3 Q (EACH ACCIDENT) <br />/ / / / S Q (DISEASE-POLICY LIMIT? <br />S Q (DISEASE-EACH EMPLOYEE <br />OTHER <br />/ / / <br />DESGTIIPTIDN OF OPERATIOMB/LDCATIOMSIVENICLES~ <br />CYPRUS EMPIRE CORP., CYPRUS <br />INCL. PERMIT #C-82-056 8 OP. <br />CDLORRDO YRMPA CDAL CO. INCL <br /> <br />STATE OF COLDRADO <br />MINE LAND RECLAMATION DEPT <br />1313 SHERMAN STREET <br />DENVER, CO 802Q3 <br />~ISPECIAL KEYS AND OPERATIONS AT OAK CREEK, COLORADO <br />ORCHARD VALLEY CORL CORP., TWENTYMILE CDAL C0.- <br />ATc9515 ROUTT COUNTY RD!27~ DRY, CREEY., CO, <br />_.._..,cAnceuAnon .. - <br />..,;,e,-..n:.w. .. .. .z.~.-u•:::n,c:....::._.:>~:i~.~:.---'W"'""-="== ~ ~---- -:tea>y <br />~ SHOULD ANV OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />F. EXPIRATI N DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO <br />I, MAIL.~ppII DAYS WRRTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE <br />~ LEFT. byOT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR <br />LIABILITY OF ANV K~Q UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. <br />~- AUTHORITFn REBRESEARA}IVE /~ I <br />~~ <br />__ _ ~ACORD C P TION TBBS <br />
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