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GENERAL53994
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GENERAL53994
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Entry Properties
Last modified
8/24/2016 8:39:22 PM
Creation date
11/23/2007 9:08:36 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1980004
IBM Index Class Name
General Documents
Doc Date
11/26/1991
Doc Name
Certificate of Insurance
From
MCGRIFF SEIBELS & WILLIAMS INC
To
MLRD
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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<br />.. __ _A <br />DECLARATIONS <br />continued <br /> <br />POLICY NO. X0250A1A90 <br />DECLARATIONS NO. 1 <br />Item 6: UNDERLYING LIMITS <br />A. As Ilsted In the attached Underlying Umlts Schedule. <br />B./ 9 500,000. Each OCCURRENCE: <br />(1) not covered by underlying Insurance; and <br />(2) not subject to aself-Insured retention Ilsted In the attached Underlying Llmlts <br />Schedule. <br />C. In the event of any CLAIM(S) arising from any single OCCURRENCE which Involves <br />two or more UNDERLYING LIMITS, the UNDERLYING LIMITS shall apply <br />Jin combination. <br />Item 7: Representative of the NAMED INSURED far the filing or receipt of any notice provided <br />for by the terms of the POLICY or for the receipt of return premium: <br />NAME /Len Rott <br />TITLE Manager of Accounting <br />COMPANY Colorado-tile Electric Association, Inc. <br />ADDRESS P. 0. Box 1149 <br />Montrose, CO 81402 <br />Item B: Representative of the COMPANY for the filing ar receipt of any notice provided for by <br />the terms of the POLICY: <br />NAME Aegis Insurance Services, Inc. <br />ADDRESS Harborslde Financial Center <br />700 Plau Two <br />Jersey Clty, New Jersey 07311-3994 <br />ENDORSEMENTS ATTACHED AT POLICY ISSUANCE: 1-15~ <br />Cowtersianed ac Jersey Clty, New Jersey <br />on January 17, 1991 <br />Aegis Ins S~ , <br />~ G <br />,' .. AuNariied ReDresentacre <br /> <br />8000 (1/9W ~. 1.2 Of 2) _ ... ~ ~ . <br />. .-. z;>;d was!%~...~ .. , .- ~ ~ ~ _ .. ~ Ji.eM?' r~-`'K=:~•=~-~,i'~~.~~~h'~i.'~~ <br />
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