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acoRV CERTIFICATE OF LIABI LITY INSURANCE GP ID DATE (MAVDD/YY) <br /> CIGF-1 07/14/03 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MASTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />`I <br />Blanchard Insurance Group Inc. <br />C~ D p <br />O <br />3 <br /> <br />P.O. Sox 60130 REVGG <br />C L <br />TER THE COVERAGE AFFORDED BV THE POLCC E <br />BELOW. <br />Grand Junctioa CO 81506 •'" <br />Phone: 970-245-8011 Fax:970-245-8016 62043 INSURERS AFFORDING COVERAGE <br />INSURED IN RA Employers Mntual Casualty Co. <br />5 MIpB:slE Bad <br />510R D <br />C.B. Minerals C~anYyc LLG9iN( INSURER C: <br />$717 Delgany Avenue iF115 <br />Pl <br />d <br />l R <br />CA 90293 INSURER D: <br />aya <br />e <br />ey <br /> INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANV REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAV BE ISSUED OR <br />MAV PERTAIN, THE INSURANCE AFFORDED BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. E%CLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAV HAVE BEEN REDUCED BY PAID CLAIMS. <br />LTR TYPE OFINSURANCE POLICY NUMBER DATE MM/DWY DATE MM/DD/YY LIMITS <br /> GENERAL LIA8IUTY EACH OCCURRENCE $ SOO,000 <br />A X COMMERCIAL GENERAL LIABILITY 1X15286 Q7/12/Q3 Q7/12/Q4 FIRE DAMAGE (Any one tire) $ 1Q Q, QQQ <br /> CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ 5, QQD <br /> PERSONALS ADV INJURY $ SD O, DQD <br /> GENERAL AGGREGATE E 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1, OOO, QQQ <br /> POLICY JET LOC <br /> AUT OMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />E <br /> ANV AUTO (Ea acritleM) <br /> ALL OW NED AUTOS BODILY INJURY <br />$ <br /> SCHEDULED AUTOS (Per person) <br /> HIRED AUTOS <br />BODILY INJURY <br />$ <br /> NON-OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE <br /> <br />(Per accident) $ <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDEN7 $ <br /> ANV AUTO OTHER THAN ~ ACC E <br /> AUTO ONLY: AGG $ <br /> EXCESS LIABILRY EACH OCCURRENCE $ <br /> OCCUR ~ CLAIMS MADE AGGREGATE $ <br /> E <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATKIN AND TORY LIMITS EA <br /> EMPLOYERS'LIABILRY <br /> _ _- _ -_- - -_ -_ _ __ _ E. L. EACH ACCIDENT E- _ _ <br /> E.L DISEASE - EA EMPLOYE $ <br /> E. L. DISEASE-POLICY LIMIT $ <br /> OTHER <br />DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />DMG Permit No. C-84-065 - Coal Ridges No. 1 Mine , East of New Castle,CO <br />South of the River. NCIG Fiaancial, Inc. and the State of Colorado Division <br />o£ Minerals & Geology are included as Additional Insureds. *10 Days Notice <br />For Non-Paymeat Of Premium **or incur substantive changes or failure to <br />renew. <br />CERTIFICATE HOLDER N ADDITIONALINSURED; INSURER LETTER:_ CANCELLATION <br />OOOODQD SHOULD ANY OF THE ABOVEDESCflIBEDPOLICIESBECANCELLED EFORETHEEXPIRATION <br />State Of COlOradO DATE THEREOF, THEISSUING INSURER WILL80DIS~MAIL *30 DAYS WROTEN <br />Division of Minerals & Geology NOTICE TO THE CERTIFlCATE HOLDER NAMED TO THE LEFT~iciAKGRE7E3CgdC9STCNkiX <br />1313 Sherman Street, Room 215 xaGCdl;Kid8:b4EaEiv56~XaiB~abd~tBXkEFFxcIS~67c~8REx7~X01R13s9©M1Yx <br />Denver CO 80203 ., <br />IEileen A. <br />(7197) <br />