GENERAL39573

• Permit No: C1980007
• IBM Index Class Name: General Documents
• Doc Date: 1/4/1993
• Doc Name: CERTIFICATE OF INSURANCE
• Permit Index Doc Type: INSURANCE
• Media Type: D
• Archive: No

CEATiFICATE OF INSURANCE
(Thit GrtiRPatt trf Inwnnet nanrltr affirtnatiwly nor negatirtlp
amtrMt, txttnda a a1Lrs tht txrvtrtgt, limits, terms a t»r,ditiont
Or tht I~ellicrtt It prCflptM.)
This: is to Certiry to
r Colorado Division of Minerals 8 Geology
Office of Mined Land Reclamation
Room #215, Centennial Building
1313 Sherman Street
Denver, CO 80203
L Attn: Christine Johnston
CIGNA Property and Cawalty Companies
Ivoaroz - DPc
ORIGINAL

JAN 0 4 ]993 ~
DIV;-:,-
~" J
III IIIIIIIII IIII III
999
COMPANY CODES
IIYt tM tolloanrg oa,cnbad Oollp or poliun. iNUad W TM COn1pa11Y tl coded bMOw. / n ~j J
tlrortdN~E aurarlo rlnlr fpr nuarw clrekad br "X" Mlcw, haw Man .awed to: I j' ,p (7 ~. G' ~ I
qN0 Atlantic Richfield Company, its Subsidiaries and subsidiaries WY (1 I
AUOR ~ thereof as now or hereinafter constituted, Atlantic Richfield IGLU ~M ~P ~ I ~Qd
INSURED Plaza, 515 So. Flower Street, Los Angeles, CA 90071 [1 ' p
corwtrre m accordano wen tea nmm tMrpl, at tea 1a11twrlne loutanld: I ~. /
Including Mountain Coal Company
© CIGNA INSURANCE COMPANY
© CIGNA INS. CO.OF TEXAS
PACIFIC EMPLOYERS INS. CO.
® INSURANCE COMPANY
OF NORTH AMERICA
® CIGNA INS. CO. OF ILLINOIS
® CIGNA INS. CO. OF OHIO
^ (07HER. - SPECIFVI FOLD
TYPE OF POLICY IIA71Y~ .~E POLICY NUMBER POLICY PERIOD LIMITS OF LIABILITY
lal Standard Workmen's statYtPrr w. c.
COmpemeLOe 8
O S Ona Accafent ono
Employee' Liihility Aggraqate Oitltle
(el General L'uhility
Pmm,a,-Oparatlpn lindutlm9 .•In
e,danW Contracp" tl Oa11nrM M/owrl

~

~
f'See 6210W Each Penon
~ ISL G1 01/01/93 to ^ Aeerdent
EaUt ~
'c ItlWpandant Contraetora ® ® 519134-A 01/01/96 ^ Occurrence
f
:

Catrpbtad Openuon,/Producn
©
9O /
tl
ContraettW, (SOaellic ryPe tl A Ie~omPNtad
Wra9a
P
dtrwlbad m lootnen
Mlaw
I ~ ~ _ _ ___ _ -_ - ~ f _ - _ _ Ow_anon,/
redate
_
_
_ _ -
Prtmltl,-0pnuam Ilncludine
"IneiMnW Contraee" n delilr0 - - / - ^ Accldant
Eat

~ MlPwrl
®
~
ISL Gi
01/01/93 to S'See Below ^ Occurnnp

519134-A
01/01/96 I
~ IrrdepaMant Contraton f Agyrepau-PramJOoar.

P CortpMtad Opantlona/Produets ~ ® S Agpragata-ComPlatM
i / OPeraoon,/Praducu
CPntrtctuM, ISpcilie rvw tl
/©
~
deacrbW In leetnota MIPwI f A9grfMJata-COnnaRUal
le) Aotomo68e L'ubiliq ~
1
~~~l o.rt.d AutanabtNa
8,~ Mind AutanrPOrM
c 8~ 8 f Eaeh Pnson i

{` I
!Ij Eaeh ^ AaWanr I
to _NPnowrwd APlnrnPbiltl 1 I
LJ 1 ~
L
I _ _ - -
- --- - f- _ - - _- r ^ O¢urnnce- ~
-
- _
- _ _ -
- - - i
OarrlW Automobdtl
~
~ Nsad AuttlnlobtNa
~
e 1) ^ AterdMt
f E~ ~ ^ Ocsvrnnn
O 1
NPnowrled Autonlobrln
(d) ' 52,000,000 Combined Single Limit,
per occurrence/aggregate where
applicable.
Cerrv„earal Faals,sr: $ublen t0 all IM Policy Kant aPPUCt01a. ,oecllic (:OntraCtWl
r aPwr.ee n woridsd tl rtlwen t is the intention of the company that in the event of
Clladl ^ a mnttact ancellation of the policy or policies by the company, ten
APt1srla ^ purt3latl order agnlemenn MtwNn the In,uratl and:
(
~ 10) days' written notice of such cancellation will be given to
^ all eonnern
sw ou at the address stated above.
NAME OF OTHER PggTV ,,,. ___. GATE pl aPPbuPlq CONTRACT NO. pt anvl
Ddi,itrwr: "InbdanUl COnIrxY' meats env rvnllM l i l Ntl or Pl,mrn, 121 NMRIMI a(IrRmeOt. !a(:fpl in COnnfCUOn .rrm COM[rIrCUOn Pr dlmOb[ron 00lIa~
rions on Pr adlaGen[ [O a gnroao. 131 uMertabnlJ to ~rgwnndr a mun¢iDahry rpwrao br mumc Pal Ordmanpe, Ucfpt m COnneCnOn wr[n wOrY lOr
ma mumtlDabry, 191 srdevac- agreement. or I51 eievnor mamtenanp agreement.
L:\UTARCO\CERTI 1 p,tieorewnuun