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GENERAL55180
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GENERAL55180
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Entry Properties
Last modified
8/24/2016 8:40:15 PM
Creation date
11/23/2007 10:06:32 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1982056
IBM Index Class Name
General Documents
Doc Date
7/2/1990
Doc Name
CERTIFICATE OF INSURANCE
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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. _. _. <br />PRODUCER <br />SEDGWICK JRMES OF TN, INC. <br />P. O. BOX 19810 <br />KNOXVILLE,TN 37939 <br />(615)584-9101 <br />CODE SUB~CODE <br />INSURED <br />CYPRUS MINERRLS CO. <br />RND ITS SUBSIDIRRY CD. <br />P. 0. BOX 3299 <br />ENGLEWODD,CO 80155 <br />• _ . r*. II I I II I II I II (III III .. k~ ~Sf~~'~'9~1 .. <br />~-:K~/.,lynw.r~99.9.-a.rawx,r,..:. I~ <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS <br />NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, <br />'' E%TEND OR ALTER THE COVERAGE AFFORDED BV THE POLICIES BELOW <br />COMPANIES AFFORDING COVERAGE <br />LETTERNYA A: OLD REPUBLIC IN5URRNCE CO. <br />COMPANY B : ~ ~~ ~ ~ ~/ <br />LETTER B <br />COMPANY`. C: `J U' ~) ICJ <br />LETTER '/ lr l ~~ <br />COMPANY M~NEU LJI'41V1, <br />LETTER D D0 ?~^( niuerlnr<I nn,. <br />COMPANY E E <br />LETTER <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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. lIMI7S SHOWN MAY HAVE BEEN REDUCED BV PAID CLAIMS. <br />CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY E%PIRATION ALL LIMITS IN THOUSANDS <br />.TR DATE (MMIDD/YY) DATE (MM/DDIYY) <br />GENERAL LIABILITY <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE OCCUR. <br />OWNER'S E CONTRACTOR'S PROT. <br />AUTOMOBILE LIABILITY <br />ANV AUTO <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />NON-OWNED AUTOS <br />GARAGE LIABILITY <br />E%CE55 LIABILITY <br />OTHER THAN UMBRELLA FORM <br />WORKER'S COMPENSATION <br />AND <br />A EMPLOYERS' LIABILITY <br />OTNER <br />R EXCESS W. C. (1 ) <br /> GENERAL AGGREGATE E @ <br /> PRODUCTS~COMPIOPS AGGREGATE E @ <br /> PERSONAL S ADVERTISING INJURY f @ <br />/ / / / EACH OCCURRENCE E @ <br /> FIRE DAMAGE (Any one lire) E @ <br /> MEDICAL E%PENSE (Any one person) f <br /> COMBINED <br /> SINGLE E <br /> LIMIT <br /> BODILY <br /> INJURY S <br />/ / / / (Per person) @ <br /> BODILY <br /> INJURY S <br /> (Per acciEenl) @ <br /> PROPERTY E <br /> DAMAGE @ <br /> EACH AGGREGATE <br /> OCCURRENCE <br />/ / / / S S <br /> 0 <br /> STATUTORY <br /> S 1 01'[10 (EACH ACCIDENT) <br />0000404603 07/01 /90 07/0 1 /91E 1000 (DISEASE-POLICY LIMIT) <br /> E 1 Q100 (DISEASE-EACH EMPLOYE <br />EX260 07/01/90 07/01/91 X1,000 <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VENICLES/RESTRICTIONS/SPECIAL ITEMS <br />(1) EXCESS W.C. RPPLIES TO THE FOLLOWING STRTES:CO,KY,PR,UT,RL,RZ,GA,ID,MT, <br />TN, NV - TWENTYMILE COAL CO., FOIDEL CREED MINE PERMIT #C-8c^-056, COLORADO <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />E%PIRA'TI^ON DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO <br />STATE DF COLORADO = MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE <br />MINE LRND RECL_RMRTION DEPT. LEFT, W1 FAILURE TO MAIL SUCH NOTICE SHALL IMP NO OBLIGATION OR <br />1313 SHERMAN STREET, SUITE c^iS LIABILITY AN ND UPON TH COMPANY, ITS AGEN SOR EPRESENTATIVES. <br />DENVER, CD 80203 AUTOO D REP ESE( ATIVE <br />\ ~ /1. <br />
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