2015-12-07_GENERAL DOCUMENTS - C1992080

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CERTIFICATE OF LIABILITY INSURANCE OATEIMMUDfYYYY) 1 11/30,t2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW_ THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: It the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Higginbotham 1300 Tenth Street Wichita Falls TX 76301 NAMNEACT Pam Esch PHDNE 940-723-0771 FAx 940-723-5309 Afc No,. E-MAIL esch hi ADDREss: p � 99inbotham.net _NA CLAIMS-MADE�ili,lR INSURER(S) AFFORDMr. COVERAGE It INSURER A: Mid -Continent Insurance Company INSURED QAKR11 INSURERB:TeXas Mutual Insurance Company 22945 Oakridge Energy Inc 4613 Jacksborc Hwy Wichita Falls TX 76302 INSURERC: INsuRERD INSURERE INSURERF : COVERAGES CERTIFICATE NUMBER: 1677961599 REVISION NHMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVJITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE INSURANCE POLICY EFF POLICY EXP 1 LTR .iNSD WY POLICY NUMBER MkiiDofYYYY 01MioDlYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY D4GLWO942551 1216/2015 12(5/2016 EACH i_i _CURRENCE $1,000,000 CLAIMS-MADE�ili,lR SMI'S=EanN Cei $100,000 MEL) E;N (Anyone person) $ X 1.000 { PERS:�NALS.MVINlURY $1,000,000 'AAL A--,GREGATELIMITAPPLIESPER GENERALAi_r_REGATE $2,000,000 PR P(DUCY F71E T E Luc PROrUCT13-CAMP/OF A3�3 52.000,000 OTHER $ A AUTOMOBILE LIABILITY 06CA002811832 12/5/2015 12/5/2016 COMBINEDGINGLE1M1 5 {Faacr-&nt! 1,000,000 X ANY ATC, BODILY INJURY (Per person) S ALL ,=J ED SCHEPULECi At IT 15 AUTOS ( � BODILYINJURY L�er2ctld8nt $' I 1 NON-CaVVNED HREDAUT05 AUTOS AMA 5 Per ��.adeat A UMBRELLA LIAB OCCUR 04XS193883 12/512015 12/5/2016 EACH OCCURRENCE $1,000,000 J X EXCESS LIAB r'L&MA" AIM,E AiarRF_��ATE 51,000,400 DED X I RETENTION $10,000 $ B WORKERS COMPENSATION IID ANElv PLOYER$' LiABILI T Y Y I N AN! NIA FF!, -ER EMEER E>CLUDEL ❑ S_ BP0001027321 7)1412016 7114/201&. �( �RrSfE EFTtH EL EAC -H ACCIDENT $1,000,000 EL DISEASE - EA EMPU3YE' $1,000,000 (Mand aton/in NH) if yes, descnbe under EL DISEASE - POLiCY LIMIT 1 $1,000,000 DESCR[PTiON !nF OPERATIONS below I DESCRIPTION OF OPERATIONS f LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more spare is required) Colorado Division of Reclamation CERTIFICATE HOLDER CANCFLLATION © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD narna and !ago are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Savage & Savage ACCORDANCE WITH THE POLICY PROVISIONS. 4610 Haystack Drive Windsor CO 80550 AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD narna and !ago are registered marks of ACORD