|
ACORbr CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MMMUYYYY)
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />11/30/2015
<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(les) 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 />Higginbotham RECEIVED
<br />RE
<br />CONTACT
<br />NAME: _Pam Esch _
<br />1300 Tenth Street
<br />-WC% .PHO 940-_723-0771 — FAX "vc• Noh940-7_23-5309
<br />Wichita Falls TX 76301
<br />WAIL : Pesch@higginbotham.net
<br />X
<br />INSURER(S) AFFORDING COVERAGE WC#
<br />INSURERA:Mid-Continent Insurance Company
<br />INSURED OAKRI1
<br />heclamation,
<br />INsuRERB:Texas Mutual Insurance Company 22945
<br />Oakridge Energy Inc Div ision of
<br />4613 Jacksboro Hwy &Safety
<br />_ _
<br />INSURI _
<br />M; �;,;q
<br />Wichita Falls TX 76302
<br />INSUREaD :
<br />LEtl'L
<br />�
<br />INSURER E :
<br />INSURERF:
<br />CC]VtKAGES rFRTIFIe-ATF IW PREICD• 1h//L4ti1-1'AU nw,c�`.0 u„ue�rn.
<br />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 />EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS
<br />INSR LTR TYPE OF INSURANCE AWL POLICY EFF POLICY E
<br />IN DWVD POLICY NUMBER MM D/WYY MID 1WVY LIMITS
<br />A X
<br />COMMERCIALGENERAL LIABILITY
<br />04GL000942551
<br />12/52015
<br />12!52016
<br />E�'=HO= FFFtn_F '1,000,000
<br />,;.jJui, li, r rJ - --
<br />FFFts1L� _iEi vI,��n,.> >100,000
<br />X
<br />1.000 -
<br />rItLE v, me v. -,on) $
<br />FEF', �L,`, UJ,.URI $1,000,000
<br />LEtl'L
<br />�
<br />A,--F'EIATF LIMIT �YFL1E-, - :-F'
<br />"Etltk HL ai,i--E�-="E $ 2 000,000
<br />- LI __T �- Err
<br />FR%)CI i_7;- _ ntF'n F �,,, $2,000,000
<br />THF,
<br />A
<br />AUTOMOBILE LIABILITY
<br />OSCA002811832 1V512015 12/52016
<br />"r1 -rJ ,L uhu
<br />(F T ar nvnh
<br />s 1,000,000
<br />- -- —
<br />D E -IL , 2 JUR , iPsr perc,.n)
<br />3
<br />HE-: ILED
<br />t•I IT -�-, �1 i7-,-
<br />i
<br />E"�LILr TJJUk, w,?ra,rlje-:!
<br />y
<br />- -- — - ---
<br />r'TrFd�'1�--- -1
<br />FF?. F�
<br />$
<br />A uMBRELLAUA6 F
<br />04X3193883 12/52015
<br />12!52016
<br />E cH •-_rRF"Fr.'-E
<br />31,000,000
<br />X L
<br />EXCESS IAB
<br />_ _ ~-! 41Pd'-C1A.-F
<br />- - - —_ —
<br />p;.=FFr cTF
<br />-
<br />31.000,000
<br />IXF=TE'I-I•4$10.000 —
<br />--------------- -+-'--
<br />--
<br />.ED
<br />B WORKERS COMPENSATION S_ BP0001027321
<br />7H42015 7/t42016
<br />X I F'EP.
<br />AND EMPLOYERS' LIABILITY YIN I
<br />�rNI
<br />' Ih FFh
<br />-- - -- -
<br />FF,-rr1IE-F/Fr:TN^,.E E -I ITIv=
<br />E L EL, -H 4_�_ CENT $1,000,000
<br />OFF rER,:•_r.tEER E _V IDES, NIA
<br />(Mandatory in NH)
<br />EL $1,000,000_
<br />Itves nr.
<br />�E ICFIPT;G;J 'F ,-FFR�TI--ti JS Le �w
<br />EL C,ISE-Q'-E' 1 --LIC, �".11T 31,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Adddtonal Remarks Schedule. may be attached if more space is required)
<br />Colorado Division of Reclamation
<br />CERTIFICATE HOLDER r`Aturcl I ATInM
<br />©1988 2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014!01) The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Savage & Savage
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />4610 Haystack Drive
<br />Windsor CO 80550
<br />AUTHORIZED RjkPReSLENTATlVE
<br />©1988 2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014!01) The ACORD name and logo are registered marks of ACORD
<br />
|