GENERAL39879

• Permit No: C1981044
• IBM Index Class Name: General Documents
• Doc Date: 6/1/2004
• Doc Name: Certificate of Insurance
• To: DMG
• Permit Index Doc Type: Insurance
• Media Type: D
• Archive: No

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, M/~,R~H ' C~R'CI~ICA'fE OF IIVSURA~ICE cH
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PRODUCER 7X13 CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
Mafsh USA IDC. NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE
800 Market Street, Suite 2600 POLICY. 7X15 LERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
St. Louis, MO 63101-2500 AFFORDED BY THE POLICIES DESCRIBED HEREIN.
COMPANIES AFFORDING COVERAGE
COMPANY
16862 GL/AL-03104 GT2
-_- _-___-_-_.- _-__-__.._ __
_ I A ACE AMERICAN INSURANCE COMPANY
.
..
_-
INSURED _ -.__ -_ _r. _. -- __. _- --_ _- _..-__-_----.~-_
_
COMPANY
Twenty Mile Coal Company g
701 Market Street, Suite 700 ~~ - - --- --- --- -- ------
St. Louis, MO 63101-1826 COMPANY
C
I COMPANY
D
COVERAGES. - "" This cedificafe supe~gedes arttJ replaces any previously Issued-Dertficate foG the polfcy.period noted pelow; ~, 11 ~, ~-
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCR IBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED.
NOT`MTHSTANDING ANV REDUIREMENT, TERM OR CONDITION OF ANV CONTRACT OR OTHER DOCUMENT VnTrH RESPECT TO WHICH THE CERTIFICATE MAV BE ISSUED OR MAV
PERTAIN, THE INSURANCE AFFORDED BV THE POLICIES DESCR IBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE
LIMITS SHONM MAV HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR D
M
I
ATE (
MIDD
VV) DATE (MMIDDIYYI
A GENERAL LIABILITY HDO 619906735 10/01/03 10/01/04
GENERAL AGGREGATE_
$ 4,000,000
X GOMAIERCIAL GENERAL LIABILITY
_
PRODUCTS-COMPIOP AGG
$ 4,000.000
::,! ~y 1
]CLAIMS MADE L_J OCCUR PERSONAL RADV INJURY $ 1,000,000
OWNER'S 8 CONTRACTOR'S PROT EACH OCCURRENCE 2,000_OOO
$
X 87Dad.FOrm"~/egdOrS +
I FIRE DAMAGE (Pny one fre) _
$ SO,000
X Covera a Included ! MED ExP AN one son $ 5,000
A AUTOMOBILE LIABILITY IISA H07943817 10/01/03 10/01/04 COMBINED SINGLE LIMIT $ 1
000
000
X~1 ANY AUTO ~ ~ ~ _ ___ _ _ ,
,
_ _ __ __ ____
_ I ALL OWNED AUTOS , BODILY INJURY $
SCHEDULED AUTOS
I i
~ (Per person)
~ __-__-_- -__ - ..-- --,
X
X HIRED AUTOS i
r ~ NON-OWNED AUTOS i
t

II
f BODILY INJURY
(Per accitlent)
__-_ --- - _-
$
__- ___ _- _-
I
I r - - - ~ - - ~-- - - - PROPERTY DAMAGE $
GARAGE LIABILITY
F I AUTO ONLY-EA ACCIDENT $
I r ANY AUTO ~ I OTHER THAN AUTO ONLY:
__ -__ _ _.-__- .._ -. EACH ACCIDENT $ _
I AGGREGATE $
E%CESS UABILITY EACH OCCURRENCE $
UMBRELLA FORM AGGREGATE _ _ __ $ - __
OTHER THAN UMBRELLA FORM $
ERS COMPENSATION-AND-`
EMPLOYERS'LIABWTV - '-- -- -- - - --- - - VJC SPATU- --~9TY
- _ TORY IIMITS1 1 ER
F "
~ D EL EACH AGCIOENT $

THE PROPRIETORI ~r { INCL
PARTNERSIEXECUTIVE ~
I
E
RR C ~li/ED _
EL DISEASE-POLICY LIMI7_ _
$_ _____ _

OFFICERS ARE-. I
EXCL EL DISEASE-EACH EMPLOVEE $
OTHER I
-I
NIIRecbls e~M °'"IOgY
OIYISUa 91
DESCRIPTION Of OPERATIONSILOCATIONSNEHICLESISPECIAL ITEMS I
COVERAGE EFFECTIVE APRIL 21, 2004 FOR THE FOLLOWING: Twentymile Coal Company, Colorado Yampa Coal Company, Shoshone Coal
Corporation, BTU Empire Corporation and BTU Worldwide, Inc.
Including Permits C-81-044 and C-82.056
The insurer will notify the Division of substantive changes in policy, including termination or failure to renew.
CERTIFICATE HOLDER - - - CANCELLATION ~ ~ -.~ .~. ..
SHOULD ANY OF TIE POLICIES DESCRIBED HEREIN BE GNNCELLED BEFORE THE EXPIRFTION ONTE THEREOF.
THE INSURER AFFORDING COVEMGE NULL E.~K"~F MAIL _ ~Q DAYS VvRITTEN NOTICE TO THE
Colorado Dept. of Natural Resources

Div. of Minerals and Geology CEflTIFICATE HOLDER NAMED HEREIN, 14NxiULIDXNR~%YIItt
1313 Sherman Street, Room 215 ~ E
Denver, CO 80203-2273
MARSH USA INC.
er: Alfred A. Peterfeso ~,~Ly,~ Q ~ ~ .~
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_,
}x .~ VALID AS OF -05/24/04 "~~