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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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.:" :.:::::::::::•::'":::'::.:.'::::::.':: ".: ~':~:::': ~::.:::..:' ::... .:.. .: .: .. .. :. ... .. ~~ CERTIFKATE NUMBER <br />CERTIFICATE OF;IN$ <br />RANCE ; <br />: : <br />U <br />;a~;~[:~Ntp-H~itEC <br />~-RSrt <br />' <br />: <br />: <br />...; <br />. <br />. <br />; <br />: . <br />. <br />. <br />.. # se122 <br />.. ... . <br />PROOUeER <br /> Y <br />I <br />1 ~ <br />~ <br />I <br />L <br />Marsh i McLenn <br />an, Incorporated IOED IV <br />NO <br />R GHf14 <br />UPONT IE <br />RTIilCATB HOLDER OTIIER TITAN TNOSE PROI <br />CE <br />s <br />1166 Avenue of the Amerlciaa THE POLICY. TIIISCF.RTIi1CATe DOES YOT AAIEW.E%TEW OR ALTERTHB <br />New York, NY 10036-2774 COY'F.RAGE.AFEORDED B\'TIIE POLICIE9 LISPED IIEREIN. <br /> COMPANIES AFFORDING COVERAGE <br /> COMPANY A CONTINENTAL CASUALTY CO <br /> IETfER <br />NWRED <br />~ <br />coMPANY g TRANSPORTATION ~ CO <br />R ~f' <br />YLL° <br />TT <br />H-G COAL COMPANY . <br />LE <br />E <br />C/O W.R. GRACE i CO. <br /> <br />1 TOWN CENTER ROAD COMPANY ~ DEC 0 4 1997 <br />IETfER <br />BOCA RATON, FL. 33486 <br /> COMPANY D <br /> LETTER <br />rylomn q <br />f MIn41:11F x (:qq~q <br />OVEHAOES: isi:.i:.::' ::::::::::::::..'..:::.:. :. ..: <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 Ofl OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY <br />BE ISSUED OR MAV PERTAIN, THE INSURANCE AFFORDED BV TH E POLICIES LISTED HEREIN IS SU&IECT TO ALL THE TERMS, CONDITIONS AND E%CLUSIONS <br />CF SUCH. ^OL!CIES. LIMITS SHCWN MAY P..4Y°_ BEEN .:EC VCEO BV PAID CLPJ!'S. - <br />CO <br />LTR <br />TYPE OF NSURANCE <br />POLICY NUMBER POLICY EFFECTNE <br />DATE IMM/DD/Y1T POLICY E%PIRATI°N <br />PATE MIA DO <br />LIENS <br /> GEN ERAL WBIITY CCP 1 668005 86 6/30/97 6/30/98 GENERAL AGGREGATE $ 2000000 <br /> ]( COMMERCl4 GENERAL LwBILLTV PRODUCTS~COMP/OP AGG $ 2000000 <br /> ~QAIM9 MAOECX~OCCUR. PERSOHAI 8 ADV INJURY E 2000000 <br /> OWNER'S COMRACTOR'3 PROT. EACH OCCURRENCE E 2000000 <br /> FIRE DAMAGE (Any on. lust $ <br /> MED. E%PENSE (Arty on. panonl $ <br /> ADT aMOeaE UAe~Tr CCP 1 668005 86 6/30/97 6/30/98 <br /> COMBINED SINGE LIMIT $ 2000000 <br /> 1( pM' AUTO <br /> ALL OWNED AUTOS BODILY INJURY IPer pusonl $ <br /> SCHEDULED AUTOS <br />BODILY INJURY IPer accitlenp <br />$ <br /> HIRED Auros <br /> NON-OWNED AlROS PROPERTY DAMAGE $ <br /> <br /> M MOE l1AB~1TY <br />AUTO ONLY ~ EA ACCIDENT <br />$ <br /> ANY AUTO <br /> OTHER THAN AUTO ONLY ' <br /> EACH AGCICENT $ <br /> AGGREGATE $ <br /> E%CESS IMB~ITY EACH OCCURRENCE $ <br /> UMBRELLA FORM AGGREGATE $ <br /> <br />OTHEn T::"N U:'~RF11F FORM ___ _ _ <br /> woRl~Rr coMPENeATgN AND WC 1 6680050 7 6/30/97 6/30/98 STATUTORY LIMITS X <br /> EMPI°'E'°HAeEnY WC 1 6680052 4 6/30/97 6/30/98 EACH ACCIDENT $ zo°DOOo <br /> DISEASE ~ POLICY LIMIT $ 2000000 <br /> DISEASE ~ EACH EM0.0YEE $ 2000000 <br /> OTTER` <br />DESCRIPTION OF GPERATIONS/LOCATIONS/VEH14E5/SPECWL ITEMS <br />THE COVERAGE AND LIMITS STATED ABOVE APPLY TO PERMIT NO C 80-003. <br />CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANV OF THE POLICIES LISTED HEREIN BE CANCELLED BEFORE THE E%PIRATION DATE <br />D1V le i0a Of Minerals and THEREOF, THE INSURER AFFORDING COVERAGE WIlODH2[BSESeBH MAIL 3O DAYS WRITTEN <br />Gaol Oyy NOTICE TO THE CERTIFICATE HOLDER NAlAED HEREIN. euT~EAxRxroexT&xat11cIi9L@~E <br />1313 Sherman Street ~(i€xx <br />~&xRR117pNI49N7@R7WWl4[RppHFR9flflNplkT!}Fa(~~3{ <br />215 Centennial Building t <br />a~sBxCCaXmb~9FtiCT''kT>n1ER'T~1PJFidk1F>h1t4P~FxT 5 <br />Denver, CO 80203 MARSHb MCLEN .I P TE <br /> BV: <br /> MMII (A/951 DASOF /2 /97 <br />PAGE: "1 OF <br />
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