My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
GENERAL54952
DRMS
>
Back File Migration
>
General Documents
>
GENERAL54952
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
8/24/2016 8:40:04 PM
Creation date
11/23/2007 9:57:30 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1980001
IBM Index Class Name
General Documents
Doc Date
3/3/2000
Doc Name
CERTIFICATE OF LIABILITY INSURANCE
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
3
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
IIIIIIIIIIIII III CERTt~iCATE Ot= LIABILITY tNSURANCE~erf: No~ ; ; DATE IMM/DD/YY) <br />~~ ~ ~~ ~~ 3/01 /00 <br />sss , . <br />PRCOU~eH - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Mdrsh Risk & insurance Serv ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />#200 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />Three Embarcadero Center <br />. <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />PD Box 193BB0 <br />San Francisco. CA 94119-3880 COMPANIES AFFORDING COVERAGE <br />COMPANY <br />Mary R. Berry A PACIFIC EMPLOYERS INS CD <br />INSURED COMPANY <br />The Pittsburg & Medway B ACE American Insurance Co <br />GOdI M707ng G0. <br />Fiddler's Green Circle <br />6400 S COMPANY MAR 03 2000 <br />. C <br />Englewood <br />CD 80111 <br />. <br /> COMPANY <br />p Division of Minerals R Genlocv <br />... .. ... <br />COVERAGES :::: .... .. ..:. ~ .... ~ - .: ~ ... <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 ANY REQUIREMENT, TERM OR CONDITION OF ANV CONTRACT OR OTHER DOCUMENT WITH RESPECT 70 WHICH THIS <br />CERTIFICATE MAV BE ISSUED OR MAV PERTAIN, THE INSURANCE AFFORDED BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY NAVE BEEN REDUCED BY PAID CLAIMS. <br />CO POLICY EFFECTIVE POLICY E%PIRATION <br /> <br />LTR TYPE OF INSURANCE POLICY NUMBER <br />DATE IMMIDD/YYI <br />DATE IMM/DD/YYI LIMITS <br />A GEN ERAL LIABILITY HDC 619888575 3/OI /OQ 3/O1 /Q1 GENERAL AGGREGATE • ], NNB. ODO <br /> ,f COMMERCIAL GENERAL LIABILITY PRODUCTS COMP/OP AGG • 1. QQQ, QQQ <br /> A' CLAIMS MADE ~OCCUR_ _ _ _ P.ERSONALb ADV INJURY • ]. QQO.ODO <br /> OWNER'Sb CONTRACTOR'S PROT EACH OCCURRENCE • ], QQQ. OON <br /> X RetrO Date FIRE DAMAGE (Any one Lrel • <br /> X March 1. 1986 MED E%P IAny ono pelsonl • <br /> AUT OMOBILE LIABILITY <br />• <br /> ANY AUTO COMBINED SINGLE LIMIT <br /> ALL OWNED AUTOS <br /> BODILY INJURY • <br /> SCHEDULED AUTOS IPe~ person) <br /> HIRED AUTOS <br />BODILY INJURY <br /> NON~OW NED AUTOS IPer acci0eml <br /> PROPERTY DAMAGE • <br /> <br /> GAMGE LIABIIDY AUTO ONIY ~ EA ACCIDENT • <br /> ANY AUTO OTHER THAN AUTO ONLY: :.: ~' ~ ~" "' "" <br /> EACH ACCIDENT • <br /> AGGREGATE • <br />B E%CEBSLIABILRY XSL 619889580 3/0]/00 3/0]/0] EACH OCCURRENCE • 3.500.000 <br /> UMBRELLA FORM AGGREGATE • 6.500.000 <br /> A' OTHER THAN UMBRELLA FORM <br /> WORNER'B COMPENSATION AHD TORY IMITS ERH~ '~~~'~~~~~~~~'~'~'~'~'~~~~~ <br /> EMPLOYERS' IIABILITY <br />EL EACH ACCIDENT <br />• <br /> THE PROPRIETORI INCL EL DISEASE ~ POIICV LIMIT • <br /> PARTNERBIE%ECUTIVE <br />OFFICERS ARE: <br />E%CL <br />EL DISEASE - EA EMPLOYEE <br />• <br /> OTHER <br />DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLEB/BPECIAL REMB (LIMITS MAY BE SUBJECT TO DEDUCTIBLES OR RETENTIONBI. <br />7hrs Certificate shall provide far personal injury and property damage as <br />a result of surface coal mining and reclamation operations including <br />arising fro/n the use of explosives at the lnsured's Edna Mine in Colorado. <br />(See reverse and/or attached for additional information.) <br />~CER71FICkTE~HOLpER.~:~; :.:~.~~ ..:~:~ :~;~ :' :~CANGEI.IATfON ~ ... .:. ~ .: <br /> BHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />Division of Minerals & Geology E%PIRATION DATE THEREOF, TXE ISSUING COMPANY WILL }~NIK/7CDQ17[17QX MAIL <br />CD Dept of Natural Resources 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. <br />Kent Gorham <br /> <br />]313 Sherman Street. Roan 215 X9dKQS-Gl[9C~870IQIX9GDS>Kri6KACXd6DL7QdF06K}NC89D[ti6Xtm74K]dA06Q4[X <br />Denver. CD 8 0203-22 73 ]NEXr~94CXIl~CCXi7F-bGC7G3EX86719i16X7NCXn1f9QP67WiX7W6-L9Gi[dGlIl9CX <br /> <br />,, .. <br />. ..... <br />ACORD 25-S 11'1951:.::~:~:~:~:::~:~:~~~:~.:::.::::.~;::'.~..~:~~~~~~.':.~:~.: ~~:~~~:~:~:~:: <br />........... <br />':.~. ~.~:~:~: ~:'.'.'.:.~:~~~~~.~:~:: .:,:..®ACORL1..C0 ... TION :4995 ~.. <br />OO7C CERTIFICATE NO 028600]-00001 <br />
The URL can be used to link to this page
Your browser does not support the video tag.