My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
2011-06-30_REVISION - C1991078
DRMS
>
Day Forward
>
Revision
>
Coal
>
C1991078
>
2011-06-30_REVISION - C1991078
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
8/24/2016 4:35:04 PM
Creation date
7/6/2011 7:41:08 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1991078
IBM Index Class Name
REVISION
Doc Date
6/30/2011
Doc Name
Letter & Application and Public Notice
From
J.E. Stover & Associates, Inc
To
DRMS
Type & Sequence
RN4
Email Name
MLT
SB1
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.
/
9
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
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 WITH 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 />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INSR <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />(MMIDD/YYYY) <br />POLICY EXP <br />(MM /DD/YYYY) <br />LIMITS <br />INSURER(S) AFFORDING COVERAGE <br />A <br />GENERAL <br />X <br />LIABILITY <br />COMMERCIAL GENERAL <br />LIABILITY <br />X <br />OCCUR <br />INSURERC: <br />680- 6239N556 <br />6/1/2011 <br />6/1/2012 <br />EACH OCCURRENCE <br />$ <br />1,000,000 <br />PR RENTED PREMIS ES 5 ( (E a a o ccurrence) <br />MIS o <br />$ <br />300,000 <br />CLAIMS -MADE <br />MED EXP (Any one person) <br />$ <br />5,000 <br />PERSONAL &ADVINJURY <br />$ <br />1,000,000 <br />GENERAL AGGREGATE <br />$ <br />2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY X 78 LOC <br />PRODUCTS - COMP/OP AGG <br />$ <br />Excluded <br />$ <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />HIREDAUTOS <br />NON -OWNED AUTOS <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ <br />BODILY INJURY (Per person) <br />$ <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />$ <br />UMBRELLA LIAB <br />EXCESS LIAB <br />OCCUR <br />CLAIMS -MADE <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />DEDUCTIBLE <br />RETENTION $ <br />$ <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICERMEMBER EXCLUDED? <br />(Mandatory In NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS <br />Y/ N <br />N /A <br />WC STATU- OTH- <br />TORY LIMITS ER <br />E.L. EACH ACCIDENT $ <br />E.L. DISEASE - EA EMPLOYEE $ <br />below <br />E.L. DISEASE - POLICY LIMIT $ <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />Hamilton Mine, Permit No. C -91 -078 <br />30 day Notice of Cancellation applies except for 10 day Notice of Cancellation due to non payment of premium. <br />/AC-COREY <br />��. CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM/DD /YYYY) <br />5/27/2011 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />First Horizon Insurance Group <br />3401 West End Ave. Suite 600 <br />Nashville, TN 37203 -1086 <br />CONTACT Linda Inman <br />PHONE 615 385 -8376 FAX <br />(A /C, No ExtI: ( ) (A /c, No): (866) 660 -0227 <br />E -MAIL <br />ADDRESS: l i n m an @f l rs th o rizo n i n s. c o m <br />PRODUCER <br />CUSTOMER ID #: 1- 01 <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURED Honeywood Coal Company <br />do John Rich/ LBMC Family Office <br />PO Box 1869 <br />Brentwood, TN 37024- <br />INSURER A :Travelers Indemnity Company <br />INSURER B: <br />INSURERC: <br />INSURER D: <br />INSURER E : <br />INSURER F : <br />COVERAGES <br />CERTIFICATE NUMBER: <br />REVISION NUMBER: <br />HAE1 <br />CERTIFICATE HOLDER <br />CANCELLATION <br />Colorado Division of Reclamation, <br />Mining and Safety <br />1313 Sherman Street, Room 215 <br />Denver, CO 80203- <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />SS <br />ACORD 25 (2009/09) <br />© 1988-2009 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />
The URL can be used to link to this page
Your browser does not support the video tag.