GENERAL44675

• Permit No: C1981047
• IBM Index Class Name: General Documents
• Doc Date: 5/27/2005
• Doc Name: Certificate of Liability Insurance
• To: DMG
• Permit Index Doc Type: Insurance
• Media Type: D
• Archive: No

acoRV CERTIFICATE OF LIABI LITY INSURANCE OPID DATE (MM/DD/YV)
EMCO-1 05/25/05
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Hlaachard Zasuraace Group Iac . HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Sox 60130 ALTER THE COVERAGE AFFORDED BV THE POLICIES BELOW.
Grand Junction CO 81506
Phone: [phone] Fax:[phone] INSURERS AFFORDING COVERAGE
INBURED INSURERA F1np10yer8 Mataal C8Sa81ty CO.
INSURER B:
SEM Constructign CO. INSURER C:
715 Horizon Drava, Snite 219 INSURER D:
Grand Jun
ti
CO 81506
c
on
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANV REQUIREMENT, TERM OR CONDITION OF ANV CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, E%CLUSIONS AND CONDITIONS OF SUCH
POLK:IES. AGGREGATE LIMITS SHOW N MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR TYPE OFINSURANCE POLICY NUMBER DATE MM/DOM/ GATE MM/DDM/ LIMITS
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
A X COMMERCIALGENERALLIARILITV 9X90868 05/10/05 O5/10/O6 FIRE DAMAGE(Anyanelire) $100,000
CLAIMS MADE OCCUR MED EXP (Any oneperson) $S, OOO
PERSONALS ADV INJURY $ 1, OOO, OOO
GENERAL AGGREGATE $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000
POLICY PECOT- LOC

], AUT
]( OMOBILE LU181LRY
PNY AUTO
9X90868
05/10/05
05/10/06
COMBINED SINGLE LIMIT
(Ea accitlenl)
$1,000,000
ALL OW NED AUTOS

SCHEDULED AUTOS
BODILY INJURY
(Per person)
E
][

X HIRED AUTOS

NON-OW NED AUTOS
BODILY INJURY
(Per accitlent)
$
PROPERTY DAMAGE

(Per eccitlenQ $
GARAGE LIABILRY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC E
AUTO ONLY: AGG $
EXCESS LIABILOI' EACH OCCURRENCE $
OCCUR ~ CLAIMS MADE AGGREGATE $
$
DEDUCTIBLE E
RETENTION S $
WORKERS COMPENSATION AND
' TORY LIMITS ER

_ EMPLOYERS
LIABILRV
__ ^_
________ ___ ^____
_ _ _
___
_
E.L. EACH ACCIDENT
$
_ E.LAISEASE-EA EMPLOYE E
E. L. DISEASE-POLICY LIMIT S
OTHER
DESC RIPTION OF OPERATIONSA.OCATIONSR/E HICLESIEXCLUSIONS ADDED SY ENDORSEME NT/SPECNL PROVISIO NS r ~\
RE: Slue Ribboa Mine-File No C-81-047. State Of Colorado, Division Of
Miaerals & Geology is included as an Additional insured.*10 Days Notice Due
to Noa-Payment Of Premium.**OY incur substantive chaages or failure to
renew.
~E~,C,- v
MAY 2 ~ ~~~~'
.,~SRDB
CERTIFICATE HOLDER N ADDITIONAL INSURED; INSURER LETTER:_ CANCELLATION UIe,~._
D D D D D D D SHOULD ANY OF THE ABOYE DESCR{BED POLICIES BE CANCELLED BEFORE THE E%PlRAT10N
State Of COlOradO DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL *30 DAYS WRITTEN
Division Of Minerals & G001ogy NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO EO SHALL
1313 Shermaa Street ROOm 215 IMPOSE NO OBLIGATION OR LIABILDY OF ANY KIND UPON THEINSUREq, RE AGENTS OR
Denver CO 80203
REPRESENTATIVES. /