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s t r VM•~ •S"rT fI/PJS ~X,w H IA°~it'`~ <br />L~ <br />~ <br />a <br />r <br />~ ~ ~ <br />- <br />J <br />~ T ~ ~'`a L. <br />III IIIIIIIIIIIIIIII <br />- ~ <br />"~' ~~ '' <br />c . <br />; <br />„ <br />' <br />` <br />- <br />. <br />. <br />. ... . <br />~ <br />R: <br />3/19/s7 <br />999 : <br />_ <br />_C__.-_ <br />'"5 LER ~ IFIO.:" ~S'JED AS A ',.a CT E3 /'? '-FOR NATICN C':LY :ND CCNFE.RS <br /> ~O RIGHTS UFON "=S CEF r L'.'-~CATE 'HDLG ~.. ~ 'IS CERTIFICATE ~i CES NOT AMEND. <br />WESTERN INSURANCE SERVICE, INC. - =ND OR ALrEF. '-E OVERAGE AFFCFCEO EY THC POL;CI`_5 EELO'N. <br />202 West 29th Street ' <br />Pueblo Colorado 81008 :~:~I~'.~NIEB .`,r=E':?^!:~?G ~v'1=::=+AG'c <br /> ~ <br /> ~ Bituminous <br />'- <br /> __-OA• J <br />.`SUFEC __ _ <br />H. L. Ldeaver <br />DBA: 0. C. Coal Mine -,,,.,FeE . ~ ~~~ <br />='"' "' <br />P.O. Box 772 xa+~~Nv <br />~ <br />Gunnison Colorado 81230 -Er=- <br /> <br /> I ~E~EII + <br />" . <br />INEB-tANB---~L--' <br />. <br />: <br />~ <br />~ <br />' <br />o~ - rte: ~ . ;. , ,... . <br />• ~ :. Y:;., .~,.; , <br />...:: <br />... <br />. <br />, , - ~ :;•.~R ': ~.: •, <br />..,:~ <br />: <br />fON -' <br />IQN DIVt <br />M <br />` <br />THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW ~ <br />AT <br />,FG~, <br />HAVE BEEN ISSUED iG 'HE!NSURED N c r nc r1iLIUY PE IOD INDICATED <br />NOTYIITHSTANDING ANY REQUIREMENT. TERM OR CO:lDITION CF ANY CONTRACT 07 OTHER OOCUI.IENT WITH PESPECT TO'l/HIGH THIS CERTIFICATE MAV <br />E3E ISSUED GR 1,1AV PERTAIN. THE INSURANCE AFFORDED BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE 7EPM5. E%CLUSIONS. AND CONDI- <br />- TIONS OF SUCH POLICIES. <br />COI ___ <br />- LTFI ~c=~ ,SUFAr:CE FOUL"'.'J:.~RER _ ~ - - •'~ - <br />_- .~.,t CC - - ~,~pp. ALL _.1.71751N THOUSANDS <br />I GENERAL LIABILITY I ~ - ~= -= ~ ~ S rj00, <br />^1=9UI.L GE':ERAL _nSlLl i'I ~ .='r - -': P.ra., . --- $ 5D0 <br />Ai ~ .-9.5 :'..CE ~~,.LP:E'.C° ~ =~En•,e, s=D':Ea[S•'.G c,.ar $ <br />l ~,EaSSO:,=,croas~~o-_c"'_ GLA 18-14-67 3/23/87 ~ 3/23/88 -~~zc~R=E':cE $ <br /> B SOad Form '=E G<r,loGE ~Arr, nq[ ; REI $ <br /> ':FDIC. E•:PF 952 d. 'LE PE950HI $ <br /> AUT OMOBILE LIABILITY <br /> dpV PUip _SL $ , <br /> ALL 0::'NEO PUTW 3DDiLr <br /> ~oR <br /> SCHEDULED aUTUS P~9 PE95o':1 $ <br /> HIRED AUi05 eooar <br />H~uar <br /> ::ON OVlp'EO PUi <br />OS IPEa <br />+COD°Hn <br />$ <br /> GARAGE ! h5iUTT -AOPEP+r <br /> DArnAGF <br /> <br />E%CESS LIABILITY <br />i - <br />-cri,AS=nw 4uGREG+IE <br /> I $ $ <br /> OrHER IRAN Ur.1BRE'_LA %pRh9 I i <br /> srAruroai <br /> YlORKERS' COMPENSA710N $ IEA[H ACCiDENiI <br /> AND <br /> <br />' <br />$ (DISEASE POLICY LlMlil <br /> EMPLOYERS <br />LIABILITY <br />$ (DISEASE EACH EMPLDVEEI <br /> <br />1 OTHER <br />DESCRIP7ION OF OPERATIONSILOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS COAL MINING - BituminouB Will comply with <br />Form 2.03.9 Stating -The policy shall include a rider requiring that the insuror notify the <br />Division whenever substantive shanges are made in the policy, including any termination or <br />failure to renew. <br />. . <br />i John Dorfer SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE E% <br />(. Mine (and Reclamation Division PIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO <br />r 423 Centennial Building MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE <br />~ BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR <br />LEFT <br />1313 Sherman , <br />203 LIABILI7Y OF ANY KING UPON THE COMPANY. 175 AGENTS OR REPRESENTATIVES. <br />Denver Colorado 80 <br />~ AUTHORIZED REPR E <br /> /'///~-/) <br />'V <br /> c+ <br /> <br /> <br />