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2012-07-03_GENERAL DOCUMENTS - C1981041
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2012-07-03_GENERAL DOCUMENTS - C1981041
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Last modified
8/24/2016 5:02:33 PM
Creation date
7/3/2012 10:28:29 AM
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DRMS Permit Index
Permit No
C1981041
IBM Index Class Name
GENERAL DOCUMENTS
Doc Date
7/3/2012
Doc Name
Certificate of Liability Insurance
To
DRMS
Permit Index Doc Type
Insurance
Email Name
MPB
SB1
Media Type
D
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No
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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 />TYPE OF INSURANCE <br />I <br />INSR <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />{MMIDDIYYYY) <br />POLICY EXP <br />(MMIDDIYYYY) <br />LIMITS <br />A <br />GENERAL <br />X <br />LIABILITY <br />COMMERCIAL GENERAL LIABILITY <br />INSURED JUL 0 '3 A(� 1? <br />American Electric Power Company, Inc. and all Subsidiaries J U ` 4J / tJ <br />1 Riverside Plaza <br />Columbus, OH 43215 L7tVIstOt 0) KCC )atTlatlO�, <br />Mining and Sa <br />INSURER B: <br />3710 - 63 - 20 <br />07/01/2012 <br />07/01/2015 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />DAMAGE TO (Ea occurrence) RENTED <br />PREMISES R or <br />$ 1000,000 <br />MED EXP (Any one person) <br />$ <br />X <br />CLAIMS -MADE <br />OCCUR <br />PERSONAL & ADV INJURY <br />$ 1,000,000 <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />POLICY PRO JECT LOC <br />PRODUCTS - COMP /OP AGG <br />$ 2,000,000 <br />$ <br />A <br />AUTOMOBILE <br />X <br />X <br />LIABILITY <br />ANY AUTO <br />ALL OWNED <br />AUTOS <br />HIRED AUTOS <br />X <br />SCHEDULED <br />AUTOS <br />NON -OWNED <br />AUTOS <br />7320 - 04 - 61 <br />07/01/2012 <br />07/01/2015 <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />1,000,000 <br />$ <br />_1_,I.,_. <br />BODILY INJURY (Per person) <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />UMBRELLA LIAB <br />EXCESS LIAB <br />OCCUR <br />CLAIMS -MADE <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />DED I I RETENTION $ <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED') <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />Y / N <br />N / A <br />WC STATU- I OTH- <br />I TORY LIMITS I ER <br />E L EACH ACCIDENT <br />$ <br />E L DISEASE - EA EMPLOYEE <br />$ <br />E L DISEASE - POLICY LIMIT <br />$ <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />Named insured includes Snowcap Coal Company,lnc. Covers all operations in the State of Colorado, X, C, U included. <br />Endorsement Cancellation Notice. <br />In the event we cancel this policy, we agree to mail prior written notice of cancellation to the name and address shown in the schedule below The number of days of <br />advance notice of cancellation sent to the names shown in the schedule shall be equal to or greater than the statutory requirement and can never be less than the <br />mandated period. <br />Schedule <br />(continued next page) <br />A` ORO CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MM/DD/YYYY) <br />06/27/2012 <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 />MCGRIFF, SEIBELS & WILLIAMS, INC <br />P.O. Box 10265 <br />Birmingham, AL 35202 <br />REC RE ' � ® fir® <br />V C <br />CONTACT <br />NAM• <br />PHONE 800-476-2211 FAX <br />tA/C. No. Extl: (A/C, No• <br />E - MAIL <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURER A :Federal Insurance Company <br />20281 <br />INSURED JUL 0 '3 A(� 1? <br />American Electric Power Company, Inc. and all Subsidiaries J U ` 4J / tJ <br />1 Riverside Plaza <br />Columbus, OH 43215 L7tVIstOt 0) KCC )atTlatlO�, <br />Mining and Sa <br />INSURER B: <br />NS URER C' <br />INSURER D : <br />INSURER E <br />INSURER F • <br />COVERAGES <br />CERTIFICATE HOLDER <br />ACORD 25 (2010/05) <br />CERTIFICATE NUMBER:UPPB3Q4T <br />CANCELLATION <br />REVISION NUMBER: <br />Colorado Department of Natural Resources <br />Division of Reclamation, Mining and Safety <br />1313 Sherman Street - Room 215 <br />Denver, CO 80203 <br />United States <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 />Page 1 of 2 © 1988 -2010 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />
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