GENERAL31726

• Permit No: C1981044
• IBM Index Class Name: General Documents
• Doc Date: 7/7/1997
• Doc Name: CERTIFICATE OF INSURANCE
• Permit Index Doc Type: INSURANCE
• Media Type: D
• Archive: No

• ~~~ ~I~'~~~IIIIII'll RECENED
V~P~'~Y~t1L~C~~ II:l ~XC~IX~~i.[r`~.e JUL 07 1997
To: Division of Minerals & Geology Date: dune 28, 1997 Division of Minerals tt, Geoloc
Address: Department of Natual Res. Re: Attachment
1313 Sherman St. Rm. 216 Fax to:
Denver, CO 80203 Elizabeth at Twentymile
970-870-2753
This is to certify that the policies designated below are in force on the date horns by this Certificate
NAME OF INSURED: CypfUS AmaX Minerals Company et al
9100 East Mineral Circle
Address: Englewood, CO 80112
TYPE OF INSURANCE POLICY I POLICT PERIOD POLIC'r LlMfra /VALUES
A) Commercial General RMGL1135325 07/01/97 - $ 6,000,000 General Aggregate
Llablllty -Claims Made 07/01/98 $ 6,000,000 Products/Completed
Retro Date:
Other States 4/1/94 Operations Agggregate
$ 1,000,000 Personal and Advetttstng
Wyoming 4/1/86 Injury
$ 1,000,000 Each Occurrence
$ 1,000,000 Fire Damage (Any One
Fire
$ 10,000 Me ical Expense (Any
One Person)
B) Auto Liability RMCA3207268 07/01/97 - $ 2,000,000 CSL Each Occurrence
07/01 /98
C) Workers' Compensation
' OC-01611904 09/01/96 -
9 WC: Statutory
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Employers
Liability
O
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7 ,0
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EL: $
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$1,000,000 Disease -Each
Employee
D) Workers' Compensation OC-01690603 09/01!96 - WC: Statutory
Employers' Liability Alaska 09/01/97 EL: $1,000,000 Each Accident
$1,000,000 Disease -Policy limit
$1,000,000 Disease -Each
Employee
E) Excess Workers' EX351 09101/96 - Statutory Excess of a Self Insured
Compensation 09/01/97 Retention: $1,000,000 any one
occurrence
This certificate of insurance neither aNirmatively nor negatively amends, extends or alters the coverage afforded by those pollcy(ies)
numbered above and issued by companies listed below.
Should any of the above described policies be cancelled before the expiration date thereof, the issuing company will endeavor to mall
60 days written notice to the above named certificate holder, but failure to mail such notice shall impose no obligation or
liability of any kind upon the company, or upon this agency.
SEVERAL LIABILITY NOTICE (LSW 1001)
The subscribing insurers' obligations under contracts of insurance to
which they subscribe are several and not joint and are limited solely to 1
the extent of their individual subscriptions. The subscribing insurers are
not responsible for the subscription of any co-subscribing insurer who
for any reason does not satisfy all or part of its obligations.
INSURANCE COMPANY(IES) ISSUING COVERAGE:
A)B) National Union Fire Insurance Company of Pittsburgh. PA
C)D)E) Old RepubliclnsuranceCo.
~~ Aon Ritk Servicl:r
Natural Ruourca
Group
Aon Rirk Srrvrru o~Ttxar, Int.
2000 Bering Drive, Suire 900 • Housron, Texas 77057-3790
Icl: [phone] • fex: [phone]

ARS?!RG-023L w/$LN (Rev. ZH])
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