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acoRO 'CERTIFICATE OF INSURANCE ;III II~II~II~II~~II~ °; i~ <br /> 5 <br />PRwLTC~ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMILTIOM <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. TN1S CERTTFTCATE DOES NOi AMEND, E%TEND OR <br />S e d g w i c k James o f T N, Inc . ALTER THE COVERAGE AFFORDED BY THE POLICIES BELON. <br />P. 0. Box 1 9 8 1 0 COMPANIES AFFORDING COVERAGE <br />Knoxville, TN 31939-2810 coMPaeY <br /> A Federal Insurance Co. <br />INSURED COMPANY ~ ED <br /> LT <br />IVi 11 i ams Fork Company COMPANY 1995 <br />P. 0. Box 187 C <br />Craig c D 8 1 fi 2 6 COMPANY Division of Ihlnerals is Geolo <br />D <br /> gy <br />COVERAGES <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, TE RM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WI1H 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 />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. L IMITS SHOWN MAY HAVE BEEN R DUCED BY PAID CLAIMS. <br />CO IYPE OF INSURANCE PIX1C'y NUMUEA POIJCY E7-FECIIVE <br />' MUCY IXNM710N <br />' <br />' UMRS <br />LTR DAIE(MMIDD/1 <br />Y) pplE(WAIDD/ <br />y1 <br />( _ ___ _ _ __ <br />A GETl ERAI. UADILITY (9 6) 3 7 1 0 0 0 1 8 1/ 2 0/ 9 5 1/ 2 0/ 9 6 GENERAL AGGREGATE E 2 0 0 0 O O O <br /> X COMMERCIAL GE <br />NEPFL LIABILITY PRODUCTS~COMP/OP AGG E <br /> r <br />XX~ OCCUR <br />S PERSONAL&ADV INJURY E ~ <br /> L <br />HADE <br />OWNER'S 8 CONT PROT EACH OCCURRENCE E l O O O O O O <br /> FIRE DAMAGE (Any ono Die) E <br /> MEP EXP (Any one Person) E 1 D D D D <br /> AUTO MOBILE LIABRfIY <br /> COMBINED SINGLE LIMIT E <br /> ANV AUTO <br /> ALL OWNED AUTOS BODILY INJURY E <br /> SCHEDULED AUTOS (Pel Pelson) <br /> HIRED AUTOS <br />BODILY INJURY <br /> <br />NON-OWNED AUTD <br />IPer ecclanell E <br /> PROPERTY DAMAGE E <br /> <br /> GAIUGE LIABILTIY AUTO ONLY - EA ACCIDENT E <br /> <br /> _ AN'/AUTO OTHER THAN AUTO ONLY: b <br /> EACH ACCIDENT E <br /> AGGREGATE E <br /> EXCESS lL1BRTIY EACH OCCURRENCE E <br /> UMBRELLA FORM AGGREGATE E <br /> OTHER THAN'JMBPELLA FORM <br /> wowoAnrrs coMPVaReDOIr AHD "- <br /> <br />IPIDYERS LIABILIT <br />F - ' - - .. - - - <br />STATUTORY LIMITS <br />E <br /> A <br />Y <br /> EALH ACCIDENT E <br /> THE PROPRIETOW <br />PARTNERS <br />EXECUT <br />E INCL DISEASE ~ POLICY LIMIT y <br /> / <br />V <br />OFFICERS ARE: E%CL DISEASE -EACH EMPLOYEE E <br /> OTHER <br /> ~ ~ ~ <br />DESCTEPnON OF OPEMTXJNSAf%'ATIDNSNQTICLES/SPECIAL fTEMS <br />INSURER WILL NOTIFY DIVISION WHENEVER SUBSTANTIVE CHANGES ARE MADE 1N <br />THE POLICY INCLUDING ANY TER MINATIDN OR FAILURE TO RENEW. THIS POLICY <br />APPLIES TO PERMIT #C-81-010 AND INCLUDES COVERAGE FOR PROPERTY DAMAGE <br />CEFfIIFlCATE HOLDER C <br /> SHDUID ANY 6 THE ABOVE DESCRIBED POLICIES BE JVIfFL BElbf€ THE <br />COLORADO DEPT O F NATURAL RE SOURCES ExPC+ATnN DATE THEREOF, THE ISSIIRTra CpAPANY VAU ETmEAVaR ro Mao <br />DIVISION O F MINERALS & GEOL OGY 1 0 wrs vmrrEN NOTx~ ro THE mTnFIrnTT=_ HoLnER NAMED ro THE L¢r <br />A T T N : KEN G O R H A M ~ <br /> <br />215 CENTENNIAL BUILDING Bur FaLUraE ro MaL sLTO~ NOnCE sHAU IMPOSE NO o~A <br />,AnoN OR LlAenrn <br />1 3 1 3 S H E R M A N S T OF ANY pND UPON THE COE~ANY, ffS ADENT$ OR nET'f€sFNrnT9~v <br />DENVER <br />CO 80203 --~/ <br />, wTHDRIgD REP <br />~~ ~i /-~~ Gam..- ..,,(di <br /> <br />ACOFUJ?SS 3/9Ci `.' -'2 ---2-2 -.__ _ .. .._". _ _ _ _.. __ _-QACOFlO CORPORATION 1993 <br />