My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
GENERAL44555
DRMS
>
Back File Migration
>
General Documents
>
GENERAL44555
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
8/24/2016 8:13:18 PM
Creation date
11/23/2007 1:08:32 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1996084
IBM Index Class Name
General Documents
Doc Date
4/2/2001
Doc Name
CERTIFICATE OF INSURANCE
Permit Index Doc Type
INSURANCE
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.
Page 1 of 1
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
iii iiiiiiiiiiiii iii <br />999 <br /> <br /> <br />,. ..., <br />T <br />... <br />. . <br />CERTt CAL: sOF:aNStlR' :C :':':::is:;:;":.::;<:;:::::i:;a::i::'s:'.i:::::.;;:;':;:;::1'= ;. <br />Fi <br />~ E <br /> <br />.... <br />.... <br />Marsh <br />PRODUCER: THIS CERTIFICATE IS ISSUED AS A MATTER OF INFOflMATION ONLY AND CONFERS NO RIGHTS UPON THE <br /> CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE POLICY. THIS CERTIFICATE DOES NOT AMEND, <br />Marsh USA IDL. EXTEND OR ALTER THE COVERAGE AFFORDED BV THE POLICES LISTED BELOW. <br />P.O. Box 36012 COMPANIES AFFORDING COVERAGE <br />Knoxville, TN 37930-6012 COMPANY <br /> A <br />865-769-7700 LETTER <br />Z I NSURANCE COMPANY <br />INSURED: COMPANY <br /> 6 <br />LORENCITO COAL COMPANY, LLC LETTER <br />C/O A.P. MAXWELL DEVELOPMENT, LLC COMPANY ~ AP <br />I <br />4422 BRYAN STATION ROAD R 0 <br /> LETTER <br />LEXINGTON, KY 40516 COMPANY <br /> p <br /> LETTER <br />' COVEAACaE58.':'r ).:r:~' ".: ~::.:.:.::~ r ~:.:. ;:'..:•:::::~"':::' `: ``>.:.:~::::.~,;.~.: ~'.:r':a::.:..";:::.;:: ".".::::r ".:'...::.:..:'.':; :::'::k::::..:. ~<: ): ~:~.::....:.:~..,. ~ ....:. <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. <br />NOTWITHSTANDING ANV REQUIREMENT, TERM OR CONDRION OF ANV CONTRACT OR OTHER DOCUMENT WRH RESPECT TO WHICH THE CERTIFICATE MAV BE ISSUED OR MA <br />PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES LISTED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES, LIMITS SHOWN <br />MAV HAVE BEEN REDUCED BV PAID CLAIMS. <br />CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTNE POLICY EXPIRATION LIMITS <br />LTR OgTE MM D DATE MM D <br />A GE NERAL LIABILITY GL09298313 1/1/01 1/1/02 GENERAL AGGREGATE $ 2000000 <br /> X COMMERCIAL GENERAL LIABILITY PP,ODUCTSCOMP OP AGG EXCLUDED <br /> CLAIMS MApE OCCUR PERSONAL 6 ADV INJURY $ 1 000 000 <br /> OWNERS GONTRACTUF'S PROS EACH OLCURflENCE E 1000000 <br /> FIRE DAMAGE An one flre $ 50 000 <br /> MED E%P An one non $ 5,000 <br /> AU TOMOBILE LIABILITY <br /> COMBINED SINGLE LIMB $ - <br /> ANV AUTO <br /> ALL OVJNED AU'GS BODILY INJURY <br />$ <br /> SCHEDULED AUTOS Per non <br /> MIRED AUTOS BODILY INJURY $ <br /> NON-OWNED AUTOS Per eccWeni <br /> PROPERTY DAMAGE $ - <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ <br /> ANY AUTO OTHER THAN AUTO ONLY: <br /> EACH ACCIDENT $ <br /> AGGREGATE S <br /> EXCESS LIABILITY <br /> EALM OCCURRENCE $ - <br /> UMBRELLA FORM <br /> OTHERTHANUMBRELLAFORM gGGREGATE $ <br /> WORKMAN'S COMPENSATION STATUTORY LIMfi4 <br /> AND EMPLOYERS LIABILITY EACH AccIDEN7 $ <br /> FnE PRCPR~i'CRI <br />P <br />T INCL DISEASE-POLICY LIMB $ <br /> AR <br />NERS/E%ECUTiVE <br /> OFCI0EP.5 ARE: EXCL DISEASE-EA EMPLOYEE $ <br /> OTHER <br />DESCRIPTION OF OPERATIONS f LOCATIONS) VEHICLES I SPECIAL ITEMS <br />RE: PERMIT pC-%-084. LOCATION: 2 MILES WEST OF SEGUNDO, CO ON HIGHWAY 12 <br />PROPERTY DAMAGE DEDUCTIBLE OF $5,000 IS APPLICABLE <br /> <br />E ..... :~~:. .. ... ... <br />.:C R 1 ~~A. ~~ ~....: ~~...::~~.: ~::, :..... ~.. .... .. .. <br />TFf .H . ....:.....::.::....::......::...::.::::::!:.::;.~::.::::.::;:~:~:::;:'.y::;.!.':;:::,:::.~:::::~;::;~... .. ::.::::;:~:':::`;:~~':a::'i';:.:~-':::::?:~:rg:•i~:.:.,,r::.::-:::.~•-:;::r~•:::;.:::;,:, :a: i:; : :;:.;: ~:~~::..::~::: <br />. C. TE OLC£ii. .. .....~ .: .. .....:.. ......... .... .... ..:...................:~...:.~..:~~CANCEtTA7Wf1.~..,...:........:::~...:,:~.:<..:~.:.~.::.~~:..,.~:~:.:..;<.,,..:...:~::......::;...~....~.:,:::~.:;:.: ~.,~~:.;:.: ~. ~:.: ....: <br />SHOULD ANY OF THE POLICIES LISTED HEREIN BE CANCELED BEFORE THE E%PIRATON <br />DATE THEREOF, THE INSURER AFFORDING COVERAGE W ILLlWO~VAlrfO MAIL <br />COLORADO DIVISION OF MINERALS AND GEOLOGY 30 OavS WRITTEN NOTICE TO THE CERTIFICATE MOLDER NAMED HEREIN, BUT FAILURE <br />1313 SHERMAN STREET R1O[IIPV9f+O'OB.XDU'A0~ <br />DENVER, CO 80203 ~,gr,p~~y~1~ <br />B flSH USA, IN A <br /> <br /> <br />. ,......... <br />~.: I: :.V '~~ B:' :: ::.... ~~ .::..::::.::: ~::... <br />
The URL can be used to link to this page
Your browser does not support the video tag.