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<br /> ACORD CERTIFICATE OF LIABI Y INSURANCE OP ID G DATE IMM/DDM/W) <br /> ABRAXPI 11 O5 03 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ' ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> EnRisk Services., Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 6100 Western Place, Suite 100 AIOV = ~ 200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Fort Worth TX 76107 1` <br /> Phone: 817-877-1884 ~ RERS AFFORDING COVERAGE NAIC# <br /> INSURED I INSURER A: sc. Paal auxplua Linea xna: <br /> INSURER B: <br /> Abraxas Petroleum Corporation <br /> <br />Ms. Carol O Brien INSURER C: <br /> P.O. BOx 701007 INSURER D: <br /> San Antonio TX 76270-1007 <br /> <br /> INSURER E: <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAKE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWRHSTANDING <br /> ANV REQUIREMENT, TERM OR CONDITION OF AN'! CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAV 8E ISSUED Oft <br /> MAV PERTAIN. THE INSURANCE AFFORDED BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES. AGGREGATE LIMITS SHOWN MAV HAVE BEEN REDUCED BV PAID CLAIMS. <br /> LTR NSR TYPE OF INSURANCE POLICY NUMBER ~ DATE MM/DD DATE MMIDDm LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE E 1,000,000 <br /> A X COMMERCIAL GENERAL LIABILITY MU05533725 09/01/03 09/01/04 PREMISES (Ea ocwrence E 100,000 <br /> CLAIMS MADE X^DLLDR - MED EXP (Any one person) E 5,000 <br /> PERSONALSADV INJURY E 1,000,000 <br /> GENERAL AGGREGATE E 2,000,000 <br /> GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG E 1,000 OOO <br /> X POLICY PRO- LOC <br />JECT . <br /> AUT OMOBILE LIABILITY ' <br />COMBINED SINGLE LIMIT <br />E <br /> ' ANV AUTO (Ea acdtlemJ , <br /> ALL OWNED AUTOS <br /> <br />~ <br />' <br />BODILY INJURY <br />3 <br /> SCHEDULED AUTOS .. _ (Per person) <br /> ' HIRED AUTOS ~ ' <br /> <br />- <br />BODILY INJURY <br />~ <br />E <br />' <br /> NON-0WNED AUTOS - (Perecdtleni) <br /> - ... PROPERTY DAMAGE <br /> <br />' <br />'(Per acntlenU E <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT E <br /> ANY AUTO OTHER THAN EA ACC E <br /> AUTO ONLY: qGG E <br /> EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE E <br /> OCCUR ~ CLAIMS MADE AGGREGATE E <br /> E <br /> DEDUCTIBLE E <br /> RETENTION Y 4 <br /> WORKERS COMPENSATION AND i TORY LIMITS ER <br /> EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE - <br />E.L. EACH ACCIDENT <br />E <br /> OFFICERIMEMBER EXCLUDE01 E.L. DISEASE-EA EMPLOYEE E <br /> H es, tlescrlbe under <br />SPECIAL PROVISIONS below <br />E. L. DISEASE-POLICY LIMIT <br />E <br /> OTHER <br /> DESCRIPTION OF OPERATIONS /LOCATIONS / VEHIG LES /EXCLUSIONS ADDED BV ENDORSEMENT /SPECIAL PROVISIONS <br /> Certificate Holder includEld as Additional Insured and Waiver of Subrogation <br /> provided as required by written contract but only to the extent~of such <br /> contract and-onlyfor operations performed by or for the Named Insured.-It - <br /> is warranted~~that no coal mining operations are being conducted~by the ~ .. <br /> Insured. ~ ~ - - - ~~ ~ - <br /> CERTIFICATE HOLDER CANCELLATION <br /> ., . ( , ~ MINEDLA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> - - - - ~ DATE THEREOF, THE ISSUING INSURER WILL MAIL 3O DAYS WRITTEN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br /> Mined Land Reclamation ' <br /> Attn: Stephen Sel£ - - <br /> 1908 County Road 214 <br /> Silt CO S16S2 - AUTHORIZED REPRESENTATIV <br />ACORD 25 (2001108) ©ACORD CORPORATION '1988 <br />