REV103090

• Permit No: C1981021
• IBM Index Class Name: Revision
• Doc Date: 4/17/1991
• Doc Name: CERTIFICATE OF INSURANCE
• Type & Sequence: SL2
• Media Type: D
• Archive: No

- ~ ". ~ III I II I II I II IIII III ISSUE GATE IMM/00/YVI
Ia1C11ie~i. :CERTIFI
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CATE;OFIN8URANCE' _ '.
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Ri000CER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
'. NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
Van Gi Lder Insurance Carp - - ------------ --
700 Broadway, Suite 1035 COMPANIES AFFORDING COVERAGE
Uo raver , C0 80203 ---------- -- - - - --- -
COMPANY
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CODE 303°837-8540 suB-CODE ~
R
__„Foya L--Insurance-Cor
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__ _ _._ -. ___-___- _- __ __ - COMPANY
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INSURED n
LETTER
- ~ ~ -' ~- - - - r4PR f nQ•I
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Flatiron Companies COMPANY
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C
LETTER
F'.0. Box ZZY~ -------- ---------
-Mined-Land
B O u L d P_ i- COMPANY
LETTER D
~eciamati

CO 80306 _
on Division
- - --- .. - - -
COMPANY
E
LETTER
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TH15 I$ TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTfiACT OR OTHEfl DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAV BE
ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. LIMITS SHONM MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
L7A TYPE OF INSURANCE POLCY NUMBER POLJCY EFFECTNE POLICY E%PIRPTON
GATE IMM/DD/YVI DATE IMM/DO/YVI ALL LIMITS IN THOU$AN05
GENERAL LMBIDTY GENERAL AGGREGATE- E 2' QQQ
A-X, COMMERCIAL GENERALLIABIDTY AST041796 6/01/90 6/01/91 PROOUCTGCOMP/OPSAGGREGATE $ 7, QQQ
_ I CLAIMS MADE _ X OCCUR PERSONAL 8 ADVERTISING INJURY $ 1 . QQQ
OWNER'S 8 CONiRACTOR'$ PROT. EACH OCCURRENCE $ 1 QQQ
. - --_--_ _-_ FlRE pAMAGE (Arty One Lrel - _- $ 5O ,
_ ^- _ _-_` MEDICAL E%PENSE (Arty one Oenanl $ _,51
AUTOMOBILE DABIDTY COMBINED
- SINGLE E
A.X.. ANVAUro 'AST041796 b/01/90 6/61191 `'_M'T _-.__.___3.000
ALL OWNED AUTOS BODILY
- IwuRr E
SCHEDULED AUTOS IPer peraonl
MWED AUTOS BODILY
-. IwuRr E
NON-ONT/ED AUTOS IPer accCeml
__
_ -
_ _ _
_-_ GARAGE LIABILITY
_.__ ___
.
.
PROPERTY S
DAMAGE
EXCESG LIABILRY EACH AGGREGATE
OCCURRENCE
A X F'LA353778 6/01/94 6/01/91 I a 5000 E _`,'0001
OTHER THAN UMBRELL4 FORM
_ _ _. ____ _ __ __ -__ __ _ ~ I
___-_- _._ _ .__ .._ _. _ .__ _ J ._,__ -
' STATNORY .. ._ _
WORKER'S COMPENSATION - -- --- -' -- - - - - -
E TEACH ACCIDENTI ~
AND ._ __ , -.._ -._ _.___.. _ __
$ (DISEASE-PODGY LIMIT)
EMPLOYERS' LUIBIDTY ~-~- -- f
$ (DISEASE-EACH EMPLOYEEIi
_ -
OTNEfl _ _ _ _ . .. _ ._ . _ _. _ _ _ _ _
DESCRIPTION OF OPERATONS/LOCATONS/VEHICLES/RESTRICGONS/SPECML ITEMS
FiF: Bourg Mine
CERTIFICATE HOLDER ~ - -
-~ CANCEtI-ATION _.• '~' _ - ~ ~• ~- ~ ~ -' - ~ ~ I
`

~ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES eE CANCELLED BEFORE THE
'
~ EXPIRATION
THE ISSUING COMPANY WILL ENDEAVOR TO
DATE THEREOF
State M I nd I_a nd Fiec L a ma t i o n -1 MAIL 3Q DAYS, 10 DAYS FOR NON-PAYMENT OF PREMIUM, WRRTEN NOTICE TO THE
P i v i s i o n CERf1FlCATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE
A t t n : Jim S' t evc ns I NO OBLIGATION OR LIPBIUTV OF ANV KING UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES
..
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1313 She1-man rAtT-eet PUTHOR12ED REPRESENTATiYE
Denver, CO 80203 ~ - `-T' ,.'~ 030327.000
I d
ACORD 28-5 (3/88) - `=-'~~ v ' ~ ~ACORD CORPORATION 7988