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~} <br />ACORD ~ <br /> <br />~ / 1 <br />~~ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON TItE CERTIFICATE <br /> NOIDER. THIS CERTIFICATE GOES NOT ANENO, E1(TEIm OR <br />Sedgwick James of TN <br />Inc <br />, <br />. <br />P. 0. ~ 8 o x 1 9 8 1 0 <br />COMPAMES AI}IDFmING COVEFIAGE <br />Knoxville, TN 37939-2810 COMPANY <br /> A Federal Insurance Co. <br />.~ COMPANY ~ ED <br />D ~t <br />COMPANY 995 <br />Hi 11 i ams Fork Company <br />P. 0. Boz 187 C <br />Craig C 0 8 1 6 2 6 ~MPU+~' Division of mlinerais tc Lieolo <br />0 <br />gy <br />..'~' ~ MY{I,~~I.i <br />"..ef. .'r .. ~' <br />~ <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE IISTED BELON HAVE BEEN ISSUED TO THE INSURED NAl1E0 AROYE FOR THE POLICY PERI00 <br />INDICATED, NOTHITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT KITH RESPECT TO NHICH THIS <br />CERTIFICATE NAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERNS, <br />ExCLUS ONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHORN AV UC D Y PA CLAIMS. <br />W TYPE OF l6lIRN6E POI1C1'1x11~i POUr.Y Pax.Y FJPOiIRIDN <br />IIiYIS <br />L1R DATE(A04DgYY1 DATE~YypO/Y1'I <br />A r~ avlL tIABINY (9 6) 3 1 1 0 0 0 1 8 7/ 2 0/ 9 5 1/ 2 0/ 9 6 GENERALAGGREWTE i 0 0 0 0 0 0 <br /> X COMMERCWL GENERAL LIPAILIIY PRODUCTSCOMPA~P AGG i <br /> CWMS ~ OCCUa <br />MADE PERSONAL6ADV PLIVRY i <br /> ovrNErrs a coNr Pacer <br />EAa, DCCIIRFIQILE <br />i 1 0 0 0 0 0 0 <br /> FIRE DAMAGE IArry one Ne) i <br /> MED EYP (Any one psrem) i 1 0 0 0 0 <br /> AUT w10~E LLA®ffY <br /> COM&NED SINGLE UMR i <br /> ANY AUK <br /> <br /> ALL OWNED AVTOS BODILY If11UaY <br /> <br />a1EDULED PUTOS <br />Per penan~ = <br /> HIfa:D AUTOS aOgLY V11VRY <br /> NON-0WNED AUTO (PereafdrM) i <br /> i <br /> PROPERrY DAMAGE <br /> GAPACf Ln~1fY UrO ON Y~ ACCIDENT i _ <br /> PNY AURI OTHERRWJ AUTO ONLY: i <br /> EACH PIX]DEDIT i <br /> AGGREGATE f <br /> EXCi~SSlM~1TY EACH OCCURRENCE i _ <br /> UMBRELLA FORM AGGREGATE i <br /> OTHER THAN UMBRELLA FORM <br /> WAi~~T10N AND <br />EMPIDYEIrS UA~f1Y STAMOaY UMIrS = <br /> EADH AfS.IDENT { <br /> THE PROPRIETOR/ <br />PARINEaS/p(ECURVE INCL DISEASE ~ POUCY UMR <br />i <br /> OFFIGEfLS RAE: E%Gl DISEASE-EACH EMPLOYEE _ <br /> OITa31 <br />DESCaPIION OF OPEINI~Dl6M1DCA^^': 'S "' ~ R96 <br />INSURER HILL NOTIFY DIVISION HHENEVER SUBSTANTIVE CHANGES ARE HADE IN <br />THE POLICY INCLUDING ANY TERMIHgT ION OR FAILURE TO RENCN. THIS POLICY <br />APPLIES TO PERMIT 8C-81-010 AND INCLUDES COVERAGE FOR PROPERTY DAMAGE <br /> <br />L. ".~.1 ~ .. i <br />CEAi1Fl('ATEHCICDEFI <br />~i- ~ .: `. <br />.: ~ .. <br />. <br />i <br /> SHOUID ANY OF TF¢ ARDVE DESai® Pall45 DE ANfF cn ffT'U(f THE <br />COLORADO DEPT O F NATURAL RESOURCES EzrvwtrDN DATE THEILOF. THE sulu+G cawaN+' EHDEnvoa r MAIL <br />D I V I S I O N O F M I N E R g L S 8 G E 0 O G Y <br />~ 1 0 nArs vnarTETI NDTCE 70 Tr¢ CETi1Fx,ATE lalDFfi NAMm To THE LETT <br />A T T N : 7FF-N--fi$it-!Yl!-H .S o s¢/t~ J~„/a s <br />2 1 5 CENTENNIAL BUILD 1 N G - - - r-"'^` "°^"` <br />elTr RAILURE To rwwL star NOT1I~ slwLesog No oeucr,TnN oR l+~ <br />aE ANV xwo Ixvrl THE c°nwaNr <br />RS =~°~rs <br />Ar~~sar <br />'^.,~ <br />1 3 1 3 S N E R M A N S T <br />DENVER, CO 80203 ` <br />_. <br />~.'~ <br />~~ - <br /> ^ <br />AURgIigD _~ I <br />_ ~-- <br />~;. ~ <br /> - _ <br />/ <br />~ y, <br />r u.f .:1 Y 21 <~2 ? z '. ~? aR.., ,.e.4-. ' , ."u - .. .,°' ,t; : ' ...@ACOFYI CpRPOFUUION 1993 <br />