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GENERAL55215
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Entry Properties
Last modified
8/24/2016 8:40:16 PM
Creation date
11/23/2007 10:07:35 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1980003
IBM Index Class Name
General Documents
Doc Date
7/6/2001
Doc Name
CERTIFICATE OF INSURANCE
Permit Index Doc Type
INSURANCE
Media Type
D
Archive
No
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,. <br />CERnFICATE NUMBER: <br />J&HTAARSH&MCtENNAN,fNC CERTiFICATEOF <br />'INSURANCE :: <br />' <br />. <br />79712 <br />,. ..: .:.!:::::.:: ~ <br />... ... ... <br />PRODUCER <br />'FIIIS CEN'I'IL'ICA I'E 11 ISSUED AS A MATTEN OF INFORMATION ONLY AND CONFERS <br />JfiH Marsh & McLennan, Inc. NO NIC.IRSIII'ON TIIE CLRTIFICATE IIOLDER OTIIER TITAN TIIOSE PROVIDED IN <br />1166 Avenue of the Americas TIIE IYII.IC1' TIIIS CERTIFICATE DOES NOT AMEND. EITEND OR ALTER THE <br />New York, NY 10036-2774 COYENAC4:n1'FONIIF.ON\'l'11E 1'OLICIF.S LISTF.O IIEREIN. <br />COMPANIES AFFOflDING COVERAGE <br />" rCIVED COMPANY A CONTINENTAL CASUALTY CO <br />LETTER <br /> <br />COMPANY <br />Nww:o JUV 2 9 1998 B <br />H-G COAL COMPANY 1>=rTER <br />C/O W.R. GRACE fl CO. <br />lsgG@010 <br />,;IP,ra <br />C <br />O <br />MERNY ^ <br />1 TOWN CENTER ROAD <br />I <br />E <br />, <br />L• <br />BOCA RATON, FL 33486 <br />COMPANY D <br />IEfTER <br />.. .. .. <br />THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANV CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAV <br />BE ISSUED OR MAV PERTAIN, THE INSURANCE AFFORDED BV THE POLICIES LISTED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND E%CLUSIONS <br />OF SUCH POLICiE&.-LIMITS SHOWN MAY HAVE BEEDLREOUCED BY PAID CLAIMS. <br />~ <br />LTR TYPE OF NSURANCE POLICY NUMBER PIX1CY EFFECnVE <br />DATE (MM/DD/IY( POLICY E%PIMTON <br />DriTE (MM OD ~~ <br /> oEN ERAL LNBIITY CCP 166809546 4/01/98 6/30/99 GENERAL AGGREGATE $ 2000000 <br /> ~[ COMMERCIAL GENERAL WBIUiY PRODUCTS~COMP/OP AGG f 2000000 <br /> CLAIMS MADE X^OCGUR. PERSONAL d AOV INJURY f 2000000 <br /> OWNER'8 CONTRACTOR'S PROT, EACH OCCURRENCE f 2000000 <br /> FIRE DAMAGE (Airy ons fire( $ <br /> <br /> MED. EXPENSE (Any one perwn( f <br /> Aur aMOe~LMein CCP 166809546 4/01/98 6/30/99 ' <br /> COMBINED SINGE UMR $ 2000000 <br /> ][ ANV AUTO <br /> ALL OWNED AUTOS BODILY INJURY (Pei person( $ <br /> SCHEDULED AUTOS <br /> A BODILY INJURY IPeI eccitlmll~ - $ - - ~ ~ - - - - <br /> HIRED <br />Ut05 <br /> NON-OWNED AVTOS PROPERTY DAMAGE $ <br /> <br /> M MOE l1ABlITY <br /> AIRO ONLY ~ EA ACCIDENT f <br /> ANY AUTO <br /> OTHER THAN AUiO ONLY <br /> EACH ACCIDENT $ <br /> AGGREGATE $ <br /> E%DE69 UABIlfY EACH OCCURRENCE $ <br /> UMBRFLA FORM AGGREGATE ~ f <br />- OTHCR-TIWN UMBREllA FORM_ _ _ _ _ <br /> WORKER9'COIiflIBllnaN AND WC 166809501 4/01/98 6/30/99 STATUTORY DMR9 X <br />~~~~ <br />~~~~~~~~~~~~~~ <br /> EMPLOYERS LIAeurY WC166809529 4/01/98 6/30/99 EACH ACCIDENT $ <br />2000000 <br /> DISEASE ~ POLICY LIMIT $ 2000000 <br /> DISEASE -EACH EMPLOYEE $ 2000000 <br /> DTI¢R <br />OESCRFRION OF OPERATIONS/LOCATIONS/VEHICLES/EPECIPL ITFMS <br />THE COVERAGE AND LIMITS STATED ABOVE APPLY TO PERMIT NO C 80-003. <br />CEpTIFlCATE HOLDER CANCELLATION <br /> SHOULD ANV OF THE POLICIES LISTED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE <br />Division OP 'Minet816 fled THEREOF, THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL 3O DAYS WRITTEN <br />Geology NOTICE TO THE CERTIFICATE HOLDER NAMED HEREIN. BUT FAILURE TO MAIL SUCH NOTICE <br />1313 Sherman Street SHALT IMPOSE NO OBLIGATION OR LIABILITY OF ANV KING UPON THE INSURER AFFORDING <br />215 Centennial Bui ld lRQ COVERAGE. ITS AGENTS OR REPR TATI 5,0 EISSU OF THIS CERTIFICATE. <br />DBIIV eY, CO 80203 J&H M.IRSHB MCLENNAN, INCORPO TED <br /> BY. <br /> MMI 1 (B/95( AUD AS OF: / 2 2 / 9 8 <br />PAGE: 1 OF 1 <br />
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