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PERMFILE137686
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PERMFILE137686
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Entry Properties
Last modified
8/24/2016 10:38:18 PM
Creation date
11/26/2007 6:22:26 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1980005
IBM Index Class Name
Permit File
Doc Date
12/11/2001
Doc Name
INSURANCE CERTIFICATE
Section_Exhibit Name
TAB 03 ATTACHMENT 3-6
Media Type
D
Archive
No
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~ACGtIgD~ ~"CERTIFI~'ATEOri= A`~BILI ~l <br />T <br />C '~ <br />F`L~ <br />as <br />' <br />.v_~.+crY&fo..,._.;i5>i.va.^u.;e~.'.•. +t... ~. ,~y <br />_ <br />.. <br />. 2s-s <br />s <br />Y-P - :- 1!FcC•iM:£3,. 5i~fY :. .z+,+~: ~...e. :. <br />PRODUCER , THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />SEDGWICK JAMES OF NJ, INC. G_57 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />~CKER FARM ROAD <br />~ COMPANIES AFFORDING COVERAGE <br /> <br />LAND, NJ 07068 COMPANY <br /> A INDEMNITY INS. CO. OF N. AMERICA <br />INSURED <br />COMPANY <br /> BI <br />SENECA COAL COMPANY COMPANY <br />1300 SOUTH YALE ~ <br />FLAGSTAFF, AZ 86001 COMPANY <br /> D <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 ANY CONTRACT OR OTHER DOCUMENT WRH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />IXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />CO <br />LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE <br />DATE (MMIDDNII POLICY EXPIRA710N <br />DATE DIWDDNYI DYITS <br />A GENERALQABIUTY GENERAL AGGREGATE f 3 , OOO , OOO <br /> j COMMERGALGENEAALUABIUTY HDO G1 896537-9 10/01 /96 10/1 /97 PRODUCTS-coMProPACG s 2, 000, 000 <br /> CWMS MADE XX OCWR PERSONAL &ADV INJURY t 1 , 000, OOO <br /> I OWNER'SBCONTRACTORSPROT EACH OCCURRENCE 51 ,000,OOO <br /> X BROAD FORM VEN DORS COVERAGE INCLU ED FIRE DAMAGE(Mywfre) f 5 0 <br /> MED E%P (My rna psrnoN f , <br /> AUTOMOBILE LIABILITY <br />A X ;ANY AUTO ISA HO 71 2926-9 1 0/01 /96 10/1 /97 COM11B'"EDSINCLEUMIr s 1 , 000, 000 <br /> X 'ALLOWNEDAUTOS BOgLV INJURY <br /> X i SCHEDULED AUTOS ~ (Per peroon) E <br /> . HIRED AUTOS BODILY INJURY S <br /> ~. NON-0WNED AUTOS (Pw °aldanB <br /> <br /> <br />I PROPERTY DAMAGE S <br /> OARAOE LIABILITY AUTO ONLY-EA ACCIDENT S <br /> ANY AUTO OTHER THAN AUTO ONLY: <br />I EACH ACCIDENT f <br /> AGGREGATE E <br /> EYCESS UABWTY EACH OCCURRENCE S <br /> UMBRELA FORM AGGREGATE f <br /> OTHER THAN UMBRELLA FORM f <br /> WORKERS COMPENSATION AND TORY_ LIMITS ER <br /> EMPLOYERS' UABWN <br />EL EACH ACGDENT <br />f <br /> THE PROPRIETOW <br />PARTNERS/EXECUTNE INCL EL DISEASE-POLICY UMR S <br /> OFFICERS ARE: E%CL EL DISEASE - EA EMPLOYEE S <br /> OTHER <br />DESCRIPTION OF OPERATIONf/LOCATIONENEHICLEt/tPECIAI ITEMS <br />COMMISSIONERS ARE HEREBY NAMED AS ADDI TIONAL INSUREDS. <br />CERTIFICATE HOLDER CANCELLATION <br />STATE OF COLORADO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE caxCEUJiD BEFORE THE <br />8 RD OF LAND COMMISSIONERS EJCPIMnoN DATE THEREOF, THE IssulNO COMPANY WILL f,lJp~1)(O(,1~A 1l9lLX <br />SHERMAN STREET , ROOM 620 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />D ER <br />CO 80203 BIkXnYii/RlExd(akKXJ6J(i(dGil~CsY~%~2cli(dbYF)il)f7S~4~1T)SrKo`bXIXel4~ <br />, <br /> 2S9c XIWXdGA6Xd{+dfrDC w1tXdWidQJ6~X a'r>1f ?e1fEYId6XdfJ(i(FJIia~~11SXTiFd~. <br /> A RIZEO RESENTA <br />a. <br />ACORD 25-S (1/95) _ ~ ~ ACORD CORPORATION 1988 <br />GERTSS_l <br />
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