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<br />. . CERTIFICATE OF INSURANCE <br /> <br />This certmes that []STATE FAR. AND CASUALTY COMPANY, Bloomington, lIIinoi. <br />D STATE FARM GENERAL INSURANCE COMPANY, Bloomington. Illinois <br />insures the following policyholder for the ooverages indicated below: <br /> <br />DEe 0 3 1997 <br /> <br />Name of policyholder L TnS'T'ONll-ANT111RSON TN~ <br /> <br />Address of policyholder 7;"0 l.Jl..lAT li''RC: {JAV c:.",.. R_?nO <br /> <br />FO~T COLLINS, CO 805?5-337? <br /> <br />Location of operations S ~ <br /> <br />Oescription of operations ENe INEI1R <br /> <br />The policies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these policies is subject to all the tenns, <br />exclusions, and conditions of those policies. The limits of liability shown may have been reduced by any paid claims. <br /> <br />%- <br /> <br />POLICY NUMBER TYPE OF INSURANCE POLICY PERIOD LIMITS OF LIABILITY <br /> Effective Date Expiration Date (at beginning 01 policy period) <br /> Comprehensive : BODILY INJURY AND <br />22-7 668-9-mmm.... ... .B.usinElS"oLi~l>ili'Y.o. mum u 4..l5~97... u.... .:4,.1 5=98.u.umo PROPERTY DAMAGE <br />This insurance includes: D Products - Completed Operations <br /> XJ Contractual Uability <br /> D Underground Hazard Coverage Each Occurrence $ <br /> XJ Personal Injury <br /> D Advertising Injury General Aggregate $ <br /> D Explosion Hazard Coverage Products - Completed <br /> D Collapse Hazard Coverage Operations Aggregate $ <br /> XJ General Aggregate Limit applies to each project <br /> D <br /> D <br /> EXCESS LIABILITY POLICY PERIOD BODILY INJURY AND PROPERTY OAMAGE <br /> Ellectlve Date Expiration Date (Combined Single Umit) <br /> D Umbrella Each Occurrence $ .HlQQQQ9 <br /> D Other Aggregate $ 20QQQQg <br /> i Part 1 STATUTORY <br /> Part 2 BODILY INJURY <br /> Workers' Compensation Each Accident $ <br /> and Employers Liabil~y Disease Each Employee $ <br /> ! Disease - Policy Umit $ <br />POLICY NUMBER TYPE OF INSURANCE POLICY PERIOD LIMITS OF LIABILITY <br /> Ellective Date Expiration Date (at beginning of policy paried) <br /> <br />Name and Address of Certificate Holder <br /> <br />If any of the described policies are canceled before ~s <br />expiration date, State Farm will try to mail a written notice to <br />the certificate holder - days before cancellation. If, <br />however. we fail to mail such notice. no obligation or liability <br />will be imposed on State Farm or its agents or representa- <br />tiv~. <br /> <br />COLORADO WATER CONSERVATION BOARD <br />STATE OF COLORADO, DEPT. OF NATL RESOURCES <br />RM 721, STATE CENTENNIAL BLDG <br />1313 SHERMAN STREET <br />DENVER, CO 80203 <br />ATTN: BRIAN HYDE <br /> <br />A~M/ll"6"" <br />,.. ,.,. <br /> <br />Agerrrs Code Slaql <br /> <br /> <br />~a.2ReY.12:.g1PrtntedinU.s.A. <br /> <br />L. FOWLER 13~~ <br />SOUTHEAST DENVER rGJ 1 <br />