GENERAL35615

• Permit No: C1984062
• 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

- (,~r ~. ~~~ ~~~~~~~I~~~~~ ~~~ RECEIVED
I,LE~~~.lt~~t~P ~~ ~1'CSI.Y~'~1~~P JUL D71997
Division of Minerals 8 Geology
~: Division of Minerals & Geology Dete: June 28, 1997
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 borne by this Certificate.
NAME OF INSURED: CyprUS AmaX MlneralS Company et al
910CEasiMineralCircie -- ----
Adereas: Englewood, CO 80112
TYPE OF INSURANCE POLICY • POLICY PERIOD POLICY LIMR$ /VALUES
A) Commercial General RMGL1135325 07/01/97 - $ 6,000,000 General Aggregate
Liability -Claims Made 07/01/98 $ 6,000,000 Products/Completed
Retro Date: Operations Aggregate
Other States 4/1/94 $ 1,000,000 Personal and Advertising
Wyoming 4/1/86 Injury
$ 1,000,000 Each Occurrence
$ 1,000,000 Fire Damage (Any One
Fire)
$ 10,000 Medical 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 -
0
/97 WC: Statutory
h A
EL
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1
000
Employers
Liability 09/
1 : $
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,
Other States $1,000,000 Disease -Policy Limit
$1,000,000 Disease -Each
Employee
D) Workers' Compensation
' OC-01690603 09/01/96 - WC: Statutory
h A
000 E
id
Employers
Liability Alaska 09/01/97 EL: $1,000,
ac
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ent
$1,000,000 Disease -Policy Limit
$1,000,000 Disease -Each
Employee
E) Excess Workers' EX351 09/01/96 - Statutory Excess of a Self Insured
Compensation 09/01/97 Retention: $1,000,000 any one
occurrence
This certificate of insurance neither affirmatively nor negatively amends, extends or alters the coverage afforded by those policy(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 mail
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
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 InsuranceCompany of Pittsburgh, PA
C)D)E) Old RepubliclnsuranceCo.
~~ Aon Risk Services
Natures! Retourcer
Group
Aon Risk Servrrer ofTexar, Inr.
2000 Bering Drive, Suite 900 • Houston, Texas 77057-3790
tel: [phone] • Cax: [phone]
e s+~' 7r/~~.~
ARS?IRG-029L w5W (Rev. ?A7)
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