GENERAL44985

• Permit No: C1984063
• IBM Index Class Name: General Documents
• Doc Date: 9/5/2006
• Doc Name: Certificate of Liability Insurance
• To: DRMS
• Permit Index Doc Type: Insurance
• Media Type: D
• Archive: No

-L4g ~ -
ERTIFICATE NUMBER
HOU-000654096-04
PRODUCER TXIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
Mafsh USA
IOC. NO RIGHTS UPON THE CERTIFICATE NOLDER OTHER THAN THOSE PROVIDED IN THE
,
112 East Pecan, Suite 2625 f~ POLICY. TNIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER TXE COVERAGE
San Antonio, TX 78205
`Y AFFORDED BY THE POLICIES DESCRIBED HEREIN.
~
M COMPANIES AFFORDING COVERAGE
~~9
~ ` COMPANY
RECEIV ° A ACE AMERICAN INSURANCE COMPANY
INSURED - ` COMPANY
'Abraxas Petroleum Corporatior6EP 0 5 2006 B Texas Mutual Insurance Company
.P.O. Box.701007
San`Antonio
, TX 78270-tD107sion of Reclamati coMPANv
_
on,
- ~ Mining and Safety C N/A

;< - COMPANY
D
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANV CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAV BE ISSUED OR MAY
PERTAIN, THE INSURANCE AFFORDED BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE
LIMITS SHOWN MAY WIVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTNE POLICY EXPIRATION OMITS
LTR DATE (MMlDD/YY) DATE (MMlDDIYY)
P, GEN ERAL LIABILITY PMGG22906173 09/01/06 09/01/07 GENERAL AGGREGATE $ 2,000,000
J( COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ 1,000,ODD
CLAIMS MADE ~ OCCUR PERSONALBADV INJURY $
OWNER'S 8 CONTRACTOR'S PROT EACH OCCURRENCE $
FIRE DAMAGE (MyOne fire) $ 100,000
MED EXP An one rsan $
A Aur oMOBILE LUBIUn PMUH08299535 09/01/06 09/01/07
1
000
000
COMBINED SINGLE LIMIT ,
,
$
Y` ANV AUTO

ALL OWNED AUTOS BODILY INJURY $
(Per person)
SCHEDULED AUTOS

HIRED AUTOS BODILY INJURY $
(Per accitlenl)
NON-OVO7JE0 AUTOS
PROPERTY DAMAGE $

GAR AGE LIABILITY
AUTO ONLY-EA ACCIDENT
$
ANY AUTO OTHER THAN AUTO ONLY: t
EACH ACCIDENT $
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $
UMBRELLA FORM AGGREGATE $
OTHER THAN UMBRELL4 FORM $
~ .B •woRNERecoMPENSATrorrAXD- -
EMPLOYERS'LIABILITY TSF-00011L6548"-- OST14/06 0$/14/07 X TORY LIMITS Eft
EL EACH ACCIDENT $ 1,000,000
THE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT $ 1,000,000
PARTNERS/EXECUTNE
OFFICERS ARE:
EXCL
EL DISEASE-EACH EMPLOYEE
$ 1,000.000
NER

DESCRIP710M OF OPERATIONS/LOCATIDNSNENICLES/SPECUIL ITEMS
Certificate holder is named additional insured as requiretl by written conVact with respects to general liability and auto liability coverages. Waiver of
Subrogation is induded in favor of certificate holder with respects to general liability antl auto liability cove2ges.
SHOULD ANT OF THE POLICIES DESCRIBED HEREIN BE CNICELLED BEFORE THE EXPIMTON DATE THEREOF,
THE INSURER AFFORDING COVERAGE HALL ENDEAVOR TO MAIL ~0 WYB MRITTEN NOTCE TO THE
Division Df Minerals 8 Geology CERTIFICATE HOfDEft NM1MED HEREIN, BUT FAIWRE TO µVL GUCH NOTICE SHALL IMPOSE NO OBLIGATION Oft
Atm: Mr. Byron Walker
1313 Sherman Street LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATNES.ORIHE
Denver, CO 80203 ISSUER OF THIS CERTIFIGTE.
MARSH USA INC.
BY: Richard D. Jeler
VALID AS OF: 08/31/06