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_ITY INSURANCE oP rD <br />SEMCO-1 GATE (MNVDD/YYYY) <br />O5 11 06 <br /> 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 />ALTER THE COVERAGE AFFORDED eY THE POLICIES BELOW. <br /> INSURERS AFFORDING COVERAGE NAIC # <br /> wsuRERa: Em to ers Mutual Casualt C <br /> INSURER B: <br /> INSDRER C. <br />IB~OG INSURER D: <br /> INSURER E: <br />QED ABOVE FOR THE POLICY PERIOD INDICgTED. NOTWITHSTANDING <br />JITH RESPECT TO WHICH THIS CERTIFICATE MAV BE ISSUED OR <br />BJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br /> <br />GATE MM/DDI1'Y I V PI TI <br />DATE MMIDD/YY LIMITS <br /> EACH OCCURRENCE $1,000,000 <br /> 05/10/06 05/10/07 PREMISES (Ea pc<urence) $100,000 <br /> MEDEICP(Anyoneperson) ES,000 <br /> PERSONAL BADV INJURY E1,000,OOO <br /> GENERAL AGGREGATE $2,000, OOO <br /> PRODUGTS•COMP/OP AGG $Z,000,OOO <br /> <br /> <br />05/10/06 <br />05/10/07 COMBINED SINGLE LIMIT <br />(Ea acutlenp E 1 OOO OOO <br />r r <br /> BODILY INJURY <br />(Per person) E <br /> BODILY INJURY <br />(Per acci0ent) E <br /> PROPERTY DAMAGE <br /> <br />(Per accitlent) E <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT E <br /> ANY AUTO OTHER THAN EA ACC 8 <br /> AUTO ONLY: qGG 8 <br /> EXCESS/UMBRELLA LIABILITY ~ EACH OCCURRENCE $ <br /> OCCUR ^ CLAIMS MADE AGGREGATE E <br /> <br /> DEDUCTIBLE E <br /> RETENTION E 8 <br /> WORKERS COMPENSATION AND <br />' TORY LIMITS ER <br /> EMPLOYERS <br />LIABILITY <br />'ANV'PROPRIETORIPARiT1ER7tXECUTIVE` _ <br />t "-` --`-- <br />-`-'- - <br />_ __ __. _ _ <br />.E.L: EACH ACCIDENT-.. _ <br />.j- - --- .- _ <br /> OFFICERIMEMBER EXCLUDED? E.L. DISEASE-EA EMPLOYEE E <br /> If yes, tlescnbe un0er <br />SPECIAL PROVISIONS below <br />E L VISEASE -POLICY LIM17 <br />$ <br /> OTHER <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLVSIONS ADDED BV ENDORSEMENT /SPECIAL PROVISIONS <br />R8: Blue Ribbon Mine-File No C-81-047. State Of Colorado, Division Of <br />Minerals & Geology is included as an Additional Insured.*10 Days Notice Due <br />to Non-Payment Of Premium.**Or incur substantive changes or failure to <br />renew. <br />CERTIFICATE HOLDER CANCELLATION <br />OO D O O O SHOULD qNY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />Stat6 Of COlOradO DATE THEREOF, THE ISSUING INSURER WILL B$NXA$fp1rLXMAIL *3O DAYB WRITTEN <br />DiVla7.On Of Minerals & Geology NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />1313 Sherman Street Roos 215 <br />Denver CO 80203 ' <br />