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- l DATE (MM/DD/YV) i <br />;CERTIFICATE OF LIABILITY INSURANCE <br />°°~ 09/lo/oa <br />ACORD <br />,N ° °;. <br />°_ . <br />ersooucEn <br />AOn Risk 6erV1Ce5, IDC Of FlOrlda THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY <br />222 Lakeview Avenue AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />Suite 510 CERTIFICATE DOES NOT A17 END, EXTEND OR ALTER THE <br />west Palm Beach FL 33401 USA COVERAGE AFFORDED B1' THE POLICIES BELOW. <br /> INSURERS AFFORDING COVERAGE <br />PxoNE~ 866 283-7124 FAx- 866 430-1035 <br />wsuaED nvsLnER A: Lexington msur 1 a <br />Oxbow carbon & Minerals LLC mscRER6- Federal insuranc <br />1601 Forum P1 <br />Attn: Donna 7. Gul bransen INSURERc <br />west Palm Beach FL 33401-8101 u5A <br /> MSLRER D: <br /> INSLRER E: <br />COVERAGES ThisCertiFcateisnotioteDdedlos i •elleadorsements,cove es,rums,canditionsandexslBSiooso -51R-May App y <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY <br />PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. <br />AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />Tt'PE OF INSURANCE <br />POLICY NUMBER POLICI'EFFECTR' <br />DATE(MNRDD\YYJ POLICt'EXPIRATION <br />DATE(MM\DD\t'1') <br />LIMITS <br />A GENERAL LIABILITY 5270634 12/61/03 12/D1/D4 EACH OCCURRENCE $1, DOB, DDD <br /> X COAfA1ERCIAL GENERAL LIABILITY FBiE DAN1AGE(Anv one fire: $50,000 <br /> CLAIMS MADE X^OCCDR MED EXPfAnv one oerson) <br /> PERSONALd ADV INIURY $1,000,000 <br /> GENERAL AGGREGATE $1,000,000 <br /> <br /> GEML AGGREGATE LIMIT APPLES PER. <br />PRODUCTS-COAfl/OP AGG <br />$1,000,000 <br /> PRO- <br />~ <br /> LOC <br />POLICY ~ IECT <br />B A UTOtIOBILE LIABILITt' 7307-72-58 09/01/04 09/01/0$ CO\DiBVED SINGLE LTABT <br /> BUSlDE55 Automobile tEa arddcm) E1, 000, DBD <br /> X ANY AUTO <br /> ALL ONTJED AUTOS BODB.Y IN1URl' <br /> (Per Person) <br /> SCHEDULED AIIIOS <br /> <br /> Ii1RED AUTOS BODILY INJURY <br /> (Per accidem) <br /> NON OWNED AUTOS <br /> <br /> PROPERTY DAMAGE <br /> (Per accidem) <br /> <br /> GARAGE LIABILITI' AUfO ONLY - EA ACCIDENT <br /> ANl'AUTO OTHER THAN EA ACC <br /> AUTO ONLY <br /> AGG <br /> EXCESS LL\BILITt' EACH OCCURRENCE <br /> <br />OCCUR CLAIMS MADE AGGREGATE <br /> _ - <br /> DEDUCTIBLE <br /> RETEMION <br /> 'C STATU- OTH- <br /> WORRERS COMPENSATION AND <br />ORY LIAfITS ER <br /> EMPL01"ERS' LIABILITt' E.L. EACH ACCmEM <br /> E L. DISEASE-POLICY LR1R <br /> E L. DISEASE-EA E1IPLOYEE <br /> OTIIER <br />DESCRIPTION OF OPERATIONSAOCATIONS/\'EHICLES/EXCLUSIONS ADDED BY ENT)ORSEAfENTISPECIAL PROVISIONS <br />CERTIFICA3'E HOLDER" '- CANCELLATION <br /> SHOULD AN1' OF THE ABOVE DESCRBIED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> <br />DI VI SI On of Minerals & Geology DATE THEREOF, THE ISSUING COMPANI'N'ILL ENDEAVOR TO MAIL <br />D T <br />THELEFT <br />' <br /> <br />Attn: Bll~ Carter , <br />}O DAYS\5 <br />RITTEN NOTICE TO THECERTIFICATE HOLDER NAME <br />O <br />' <br /> <br />1313 Sherman Street, Room 215 O OBLIGATION OR LIABILITY <br />gUT FAEURE TO DO SO SHALL IMPOSE N <br /> <br />Denver co 80203 u5A OF ANI'KINDUPoN THE COM1IPANY, ITS AGENTS OR REPRESEMATIVES. <br /> AUTHORIZED REPRESENTATIVE /- <br />/ <br />/~ <br />,~_,i_ <br />C <br />F <br />/ <br /> !, <br />`- <br />_ <br />Z! <br />` <br />ACORD 2 -5 7197 ' °, <br />D CORP -RATIbN~79S ' <br />ACO <br />B <br />v <br />r= <br />.c <br />d <br />9 <br />`m <br />a <br />0 <br />2 <br />V <br />V <br />Ol <br />O <br />O <br />O <br />i <br />d <br />a <br />L <br />.~ <br />U <br />~~,1~ <br />-' 1 <br />R <br />~a <br />~_ <br />