GENERAL46368

• Permit No: C1996084
• IBM Index Class Name: General Documents
• Doc Date: 9/15/1997
• Doc Name: CERTIFICATE OF LIABILITY INSURANCE
• Permit Index Doc Type: INSURANCE
• Media Type: D
• Archive: No

ERT~'FICATE QF LIABILITY' INSURANCE ;eaGe i of
aSEP ~99
,
999 .. ...... ...... .. ....:..:.. .:: ..... .... .. .... ...
PRODUCER 79256 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Willis Corroon Corporation of Birmingham ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1927 First Ave. North HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 71587 (35202) ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Birmingham AL 35203 COMPANIES AFFORDING COVERAGE
[phone]
National Union Fire Ins. Co. of Pittsburgh, PA
COMPANY
Betty Hollis A
INSURED
COMPANY
B
Lorencito Coal Company, LLC COMPANY
C
1311 Bentwood Drive

Evansville IN 47711 COMPANY
D
. ..........
:.COVERAGES:~::~:~ ::::.::..:.:..::..~.;~::~:~~::::::~:~~:~:~:~~.~:~:~::::.~..~::::::~:~~.:~~.:~~:~:::::.~:~::'.:~::::::::::.::.:.:::::~::~::::::~:~:~:~::~:::.~~~~::~::~:~:~ :.. ..........:.......~
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAV BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAV HAVE BEEN REDUCED BV PAID CLAIMS.
CO rypE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY E%PIRATION UNITS
LTR DATE (MM/DD/YY) DATE (MM/DD/VY)
A GEN ERAL LUBIUTY GL5652470RA 24JAN-1997 24JAN-1996 pENERAL AGGREGATE f 2,000,000
X COMMERCIAL GENERAL UABIUTV PRODUCTSGOMP OP AGG S 1.000,000
CUIMS MADE ~ OCCUR PERSONALA ADYINlURY S 1.000.000
OWNER'SB CONTRACTOR'S PROS EACH OCCURRENCE f 1,000,000
DRE OAMAGE An one lira f 50.000
MED E%P An ane rson 5,000
AU TOMOBILE LIABILITY C
COMBINED SINGLE LIMIT S
ANY AUTO
ALLOWNEO AUTOS ~ 1997 BODILY INJURY

SCMEOULED AUTOS SEp
(Par parson) f
HIRED AUi~
In & Vew~;,,
BGDILV INJDRY
f
NON-0WNEO AUTOS
islon of hUner
Dl IPer acatlant)
v PERTY DAMAGE
PR
O f
GARAGE LIABILffY AUTO ONLY ~EA ACCIDENT f
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDEI~fT f
AGGREGATE
E%CESS LIABILITY EACH OCCURRENCE f
UMBRELLA FORM gGGREGATE S
OTHER THAN UMBRELLA FORM
WC STATU~ OTH-
WORKERSCOMPENSATIONAND TORY LIMITS R
EMPLOYERS' LIABILITY
-- - _ EL EACH ACCIDENT S _ _
THE PROPRIETOR/
PARTNERS/EXECUTIVE INCL EL DISEASE-POLICY LIMIT f
OFFICERS ARE E%CL EL OISEASEEA EMPLOYEE
OTHER
DESCRIPTION OF OPERATIONSILOCATIONS/VENICLES/SPECIAL ITEMS
RE: Permit No. C-96-084 Location: 2 miles West of Segundo, CO. on Highway 12
CERTff1CATE'HOLDER ~: .. ~ ~ ~ : CANCELEJtT[ON
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL >E4DfN Ira MAIL
Colorado Division of Minerals and Geology 3O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
1313 Sherman Street BIrR IFANLNF%A711WMN)61N%NNOS®(SIIAfOX NLN7tl~lODTaNCNm7rIDM S1(COI~InOR%%
Room 215 00X%ANY%NNNB%ANNNA Z7p>p%% XfPB(%AtlMMTSXppX XM~%IBDf%%
Denver CO BO2O3 AUTRESENT E, / _
~ACORD 25-S 795 ~~~~~~: ~':~.. .:.~~ ::~:~:.'.:.': .VAA1Dll52~.':~... ~.: .:: :~ ~:.':.:. ~.: ~~~~:.'.:':.~: ~.::~: ;'::'. ~: ~.:~ ~: ~~ACDRD CORPORATfON 1988 ~~~