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GENERAL53764
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GENERAL53764
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Entry Properties
Last modified
8/24/2016 8:39:12 PM
Creation date
11/23/2007 8:54:22 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1984062
IBM Index Class Name
General Documents
Doc Date
11/17/1998
Doc Name
CERTIFICATE OF INSURANCE
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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~~ ~ertif f cats o f ~1u~ur~r~ce 999 <br />flora Ruk Servacer <br />TO: Division of Minerals 8 Geology Rg: Attachment <br />Department of Natual Res. Fax lo: <br />1313 Sherman St. Rm. 216 Tracey at Twentymile <br />Denver, CO 80203 970-87(L7753 <br />RECEIVED <br />ASSUred: Cyprus Amax Minerals Company et al N~V 2 ] <br />9100 East Mineral Circle <br />Englewood, CO 80112 <br />DIV. OF MINERALS <br />& GEOLOGY <br />Thla Is b cemry met the polkles ollnsurance Ilsfed 6akw have been Issued b Me Insured named ebow Iw me polky perrod Intlkehrd, nolwlmaferxHrq any <br />requlrentenf, term, a condlnon of any canhacf oromer document wlm respect b whkh Ihla certlncele may be Issued w may perteln. The Insurance ellondad by <br />me polkles ckscdbedhereln Is sub/ecf ro eU me lerrra, exclusbne end conWnona d such polkbs. LIMfs shown may have been redreed by peld clelms. <br />Type of <br />Insurance Policy <br />No. Policy <br />Period Policy <br />LimitsNalues <br />A) Commercial General RMGL6121972 07/01/98 - $ 6,000,000 General Aggregate <br />Liability 07/01/99 $ 6,000,000 Products/Compleled <br /> Operations Aggregate <br /> $ 1,000,000 Personal and <br /> Advertising Injury <br /> $ 1,000,000 Each Occurrence <br /> $ 1,000,000 Fire Damage (Any One <br /> Fire) <br /> $ 10,000 Medical Expense (Any <br /> One Person) <br />Insurance Company(ies) National Union Fire Insurance Com pany of Pittsburgh, PA <br />B) Auto Liability RMCA3209148 07/01/98 - $ 2,000,000 CSL Each Occurrence <br /> 07/01 /99 <br />Insurance Company(ies) National Union Fire Insurance Company of Pittsburgh, PA <br />C) Workers' Compensation OC-01611906 <br />Employers' Liability <br />09/01/98 - WC: Statutory <br />09/01/99 EL: $1,000,000 Each Accident <br />$1,000,000 Disease -Policy Limit <br />$1,000,000 Disease -Each <br />Employee <br />Insurance Company(ies) Old Republic Insurance Co. <br />D) Excess Workers' EX358 09/01/98 - Statutory Excess of a Self Insured <br />Compensation 09/07/99 Retention: $1,000,000 any one <br />occurence <br />Insurance Company(ies) Old Republic Insurance Co. <br />The subscrtblrq Insurers od/peflons undo. cronfracla oI Insurance ro which may subscribe ere serera/ end nor plot end ere llmhetl sdely ro the extant d melt <br />Ind/Nduersubscrtprkns. the subscdblrp Insurers era nor responsible ro~me subscdptbn aenycosunscrwxplnsu,er woo lcveny,aesnn mss oar sansry en cv <br />pen d Its obligenons. <br />This cert~eale is Issued as a mallet of inlormelion only end coolers no rights upon the cedificala holder. This cedif¢ale does not emend, extend a alter the <br />coverage aflordad by the policy(ies) shown hereon. Should any of the above described policies be canceled belore the expiration date Ihereol, Ihis aganry, on <br />bahall of the issuing company(ias), will ~embemmcb mail 60 days written notice to the above named cedificate holder, hell <br />enq. <br />Date: November 17, 19913 <br />Aon Risk ervices of Texas, Inc. <br />1 <br />By: / ~ ~~ <br />rl on Fr,k ~nri„r nl '(..n. hrr. <br />21100 OcrinKK Drice, Swm 900 • Houuon, Texas 77057-3790 • cal: (71 3) 430-0000 • fax: (713) 430-6590 <br />H \CLIENTSV1on\CYPRUSPOLICIESLLeau }1,99\148-754 rip riot <br />71/17N8 12 76 PM <br />
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