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APPCOR12787
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APPCOR12787
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Entry Properties
Last modified
8/24/2016 6:33:10 PM
Creation date
11/19/2007 2:34:26 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981041
IBM Index Class Name
Application Correspondence
Doc Date
1/4/1981
Doc Name
CERTIFICATE OF INSURANCE
Media Type
D
Archive
No
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..' f~. "i1~~ ~ 1~ ./•'I. Ix.: ~' ~I. 'M' ~.~A~i.• <br /> <br />'<. yr"t..~,,S <br />yr~'lj .t°}; rbirL'"iy <br />i r <br />7 <br />• <br />~~.~~. I: w(~r •. r~.. III , <br />. ::1.~. 'rt5'M !ti .~,.r 1 <br />i*~.~':• °~~,.' Y I~ t{~~{III IIIIIIIIII'll <br />, <br />v <br />~_ <br />, <br />I <br />'' ] <br />9 <br />"~ <br />l__^~,~ <br />Y <br />p <br />(,~VI ~rT • <br />ra , <br />99 <br />Y tw` <br />7iln a~q o <br />i. ~'N <br />v a <br />N°M( 1ND 4DUR('A (lf AG[N('Y <br />Frank B. H:~ll & Co. of Mass., Inc. COMPANIES AFFORDING COVERAGES <br />89 Broad Street <br />Mass. 02110 <br />Boston ~,,°n~(F"` A Insurance Company of North America <br />, <br /> cDMFAr„ <br />[rnIP B Old Republic Insurance Company <br />nAM[ AND ADURC55 d NSURCD ~+ <br />P° <br />Powderhorn Coal Company COM <br />"Y C <br />LIiiCR <br /> <br />East of Grand Junction, Colorado <br /> JMPANY D <br />Y" <br /> Lf TiCR <br /> CONPANV C <br />L <br /> LCTi[R <br />This li to cenlty foal poLUes of insurance listed below have been Issueo Lo toe insured nametl above and are In lone at ves hme NoMifh5lan0~ng any reQmremenl. te.m or condd~oN <br />01 any ooniract or other document wlih respect 1o whlcN this ceniLCate may be issued or may pena~n, Ina i^sura NCe aHOrded by the pol¢,e5 desorit+ed harem q su LIKI to all the <br />terms. exolus~ons and oondltions of such polltles <br />. ')MPPNY R~L I:` Limits of Liabili Yin Thousan ds 1 i <br />lEiiER TYP{Of WSURANf,F POLICv NUMHLR [%pqus~lOY pAR f4CH AGGR(Ga r[ <br /> OCCURR[NQ <br /> GENERAL LIABILITY <br /> eOCI[r lNJUpr s s <br />A ©COMPq(HENSIV[ FORM TO BE DETERMINED 6/1/82 <br /> ^PRCM15E5-OpERAi~ONS PHDnI RIr DAMALI 1 ~ <br /> ^ [x PlOS~DN 4ND COLLAPSE <br /> HAZARO <br /> ^ UNDERGROUND HA7ARp <br /> ^ PPODUCTS: COMPI ^ [ O <br /> OPL'Pn11ON5 H42ARD <br />^ BODCV R•JURV AND <br />000 <br />l <br />000 <br />l <br /> CONiRACiUAL INSURANr[ PRJP[Ri1pAMnO[ S <br />, , <br />, <br /> ^ DROeD iDRM PROPL Rig COMD~NCO <br /> DAMAOI <br />^ INDCP(ND[N1 LONI FAC TORS <br />" <br /> ^ PCR50NAl INJURE R[usONA; iN /DR\ S <br /> AUTOMOBILE LIABILITY H">~•^N'ua. s <br /> ![ A! .~ PL P.SJN I <br /> JJ~~ <br />LLJ COMPRGI[N51VC fORM TO BE DETERMINED 6/1/82 aoyu INnIR• s <br />A ^DwHCU fE4CH ACUDENiI <br /> <br />^ HIRCD FPDPLFi~ DeM4Gl S <br /> bODrtY INJURY ANO <br /> NON ONM1CD pR'JP[RiY DANAGI f 1 r QQQ <br /> f.OM RIH[U <br /> E%CESS LIABILITY <br /> aOp~. ` INJURr AND <br /> ^ UMDRFLLA FORM PPVGC RiV DAMLGI f S <br /> ^ OTH(RTHAN UMRRCI[A LOMBINCU <br /> f OPM <br /> WO(tNERS' COMPENSATION sr Aiur Opr <br />B ~ and BC 47038 7/1/82 <br /> EMPLOYERS'LIABILITV ~~~ 'lUD .-. ~I,L' <br /> OTHER <br />'sCRIPiION OL OPCRAIIOYCgOC AiIONSN[HICLCS ' <br />qr 3n e~qrria Yy c anaae <br />Cancellation: Should any of the above described pobcles be cancelle(yte~re the e%plrahon date I ereof, the isSUing com~ <br />pany wills mail ~~_ days wntlen notice to the below' named cerilhcate holder,ls]mCk700oC]oL <br />N<M( e.YD ADDp[5,. Dr ,;~ p11f ILAi [ HOL DI P <br />Colorado Department of Natural Resources DA~(ISSUm Janu 4 1981 <br />_ <br /> fined Reclamation Board F.B. Hall & Co. o ass., nc. <br /> fined Land Reclamation Development J- <br /> ,. <br />, <br />~ <br /> 1313 Sherman Street ~"" ' ~ _ ' <br />~0 <br /> enver, Colorado 80203 AUIHORIICU RL PRLjF~ITI[11J1 <br />4^ 7Y 1 10~ <br />
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