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Af;/11'~11. CERTIFICATE OF 11VSURANCE D+~ME~~~, ~y <br />PRODUCER m~ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />SEDGWICK JAMES OF NJ, INC. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />3 BECKER FARM ROAD G-5 ~ COMPANIES AFFORDING COVERAGE <br />ROSELAND, NJ 07068 COMPANY <br /> A INS. CO. OF NORTH AMERICA <br />INSURED <br /> COMPANY <br /> B <br />POWDERHORN COAL COMPANY COMPANY <br />SUBSIDIARY OF WESTERN ASSOC. COAL COR P C <br />P. O. BOX 14 3 0 ~ COMPANY <br /> D <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, TERM OR CONDITION OF ANV CONTRACT OR OTHER DOCUMENT WITH 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />CO <br />LTR TYpE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION 11MR5 <br /> DATE (MMIDD/YY) DATE (MMND/YY) <br />A GE NERAL LIABILITY GENERAL AGGREGATE S <br /> COMMERCIAL GENERAL LIABILITY CGO GL 658779-5 lO~O1~94 10~1~95 PRODUCTS COMP/OP AGG S / <br /> CLAIMS MADE ~b ' <br /> _ CCUR PERSONALBADV INJURY S <br /> OWNER'SS CONT PROT EACH OCCURRENCE S ~ <br /> BROAD FORM VE DORS COVERAGE INCL DED FIRE DAMAGE IAny ane Lrel E <br /> <br /> MED E%P (Any ane personl S ' <br /> <br /> AU TOMOBILE LIABILTY <br />A X ANYAUTO SCA HO 635052-5 10/01/94 10/1/95 COMBINED SINGLE LIMIT a 1 (fQQ, QQ <br /> X ALL OWNED AUTOS <br />BODILY INJURY <br />S <br /> X SCHEDULED AUTOS (Per personl <br /> X HIRED AUTOS <br />BODILY INJURY <br />E <br /> X NON~OWNEO AUTOS (Per accitlenil <br /> <br /> -- PROPERTY DAMAGE § <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT f <br /> ANY AUTO OTHER THAN AUTO ONLY <br /> EACH ACCIDENT S <br /> AGGREGATE S <br />~ E%CESS LIABILT' EACH OCCURRENCE S <br /> L UMBRELLA FORM AGGREGATE § <br /> OTHER THAN UMBRELLA FORM § <br /> WORKERS COMPENSATION AND STATUTORY LIMITS <br /> EMPLOYERS' LIABILITY <br /> EACH ACCIDENT E <br /> THE PROPRIETOR/ INCL DISEASE ~ POLICY LIMIT E <br /> PARTNERS/E%ECUTIVE <br /> OFFICERS ARE: E%CL DISEASE -EACH EMPLOYEE S <br /> OTHER <br />DescRIPnDNOFDpERATIONS/LOCnnDPF.Iop}}IIE~6PERATIONS IN STATE OF C <br />POWDERHORN COAL CO.: ROADSIDE, SOUTH PROTAL AND ROADSIDE; NORTH PROTAL, <br />INCLUDES DAMAGES FROM SURFACE COAL MINING OPERATIONS, USE OF EXPLOSIVES & <br />DAMAGE TO WATER WELLS. <br />CERTIFICATE HOLDER CANCELLATION <br />COLORADO DEPT OF NAT' L RES . SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />DIV. OF MINERALS & GEOLOGY E%PIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL <br />1313 SHERMAN STREET, ROOM Z 1 S 3 Q DAYS WRITTEN NOTCE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />DENVER, CO BO2O3 BUT FAILURE TO MAIL SUCH NOTICE SHALL OSE NO OBLIGATI OR U <br /> OF ANY KIND UPON THE COMPAN N OR REPR YES. <br /> AUTHORIZED REPRESENTATIVE <br />ACORD 25 S (3/93) O ACORDCORPORATION 1993 <br />