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ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID DATE (MMIDD/YYYY) <br />SEMCO-1 O5 10 07 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />HIIB International Southwest ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Blanchard Insurance Group HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />P.O. Box 60130 ' ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Grand Junction CO 81506 <br />Phone: 970-245-8011 Fax: 970-245-8016 INSURERS AFFORDING COVERAGE NAIC# <br />INSURED INSURER A: Em 10 erS Mutual Casualt C <br /> INSURER 0: <br />SEM Construction CO. INSURER C: <br />627 24 1/2 Rd, IInit I INSURER D: <br />Grand Junction CO 81505 <br /> <br /> INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANV REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAV BE ISSUED OR <br />MAV PERTAIN, THE INSURANCE AFFORDED BV THE POLICIES DESCRIBED HEREIN IS SUDJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAV HAVE BEEN REDUCED 8Y PAID CLAIMS. <br />LTR NSR TYPE OF INSURANCE POLICY NUMBER P L FFE TIV <br />DATE MM/OD/YV P L V E P <br />DATE MM/DD/YY LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1 r OOO r OOO <br />A X COMMERCIAL GENERAL LIABILITY 9X90868 D$~1D~D7 DS~1D~D8 PREMISES (Eaa'curence) S1DDrDDD <br /> CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ 5 r D DD <br /> PERSONAL B ADV INJURY b 1 r OOO r OOO <br /> GENERAL AGGREGATE $ 2 r OOO r OOO <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ZrDD~r DGD <br /> POLICY PRO- <br />JECT LOC <br /> AUT OMOBILE LIABILITY <br />COMBINEDSINGLELIMIT <br />$1rDDDrDDD <br />A X ANVAUTO 9X90868 DS~iD~D7 D5~1D~D6 (Ea aaidenq <br /> ALL OWNED AUTOS <br />BODILY INJURY <br />$ <br /> SCHEDULED AUTOS (Per person) <br /> X HIRED AUTOS <br />BODILY INJURY <br /> <br />X <br />NONAWNED AUTOS <br />(Per accident) $ <br /> PROPERTY DAMAGE <br /> $ <br /> (Per acdtlenU <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S <br /> ANV AUTO OTHER THAN EA ACC E <br /> AUTOONLV: AGG E <br /> EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ <br /> <br /> OCCUR ~ CLAIMS MADE AGGREGATE $ <br /> <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND <br />' TORY LIMITS ER <br /> EMPLOYERS <br />LIABILITY <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ <br />- - -OFFICERIMEMBEREXCLUDED?-- -- - - '~- -- -- -- <br />E.L.DISEASE-EA EMPLOYEE <br />E <br /> I( es, describe under <br /> SPECIAL PROVISIONS belay E.L. DISEASE -POLICY LIMIT E <br /> OTHER <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES /EXCLUSIONS ADDED BV ENDORSEMENT /SPECIAL PROWSIONS <br />RE: Blue Ribbon Mina-File No C-81-047. State Of Colorado, Division Of <br />Minerals & Geology is included as an Additional Insured.*10 Days Notice Due <br />to Non-Payment Of Premium.**Or incur substantive changes or failure to <br />renew. <br />V CRIIr ItiAIC nVLUCK l.AnI:CLLAIIVn <br />State Of Colorado <br />Division Of Minerals & Geology <br />1313 Sherman Street Room 215 <br />Denver CO 80203 <br />D D D D D D D I SHOULD ANV OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI <br />DATE THEREOF, THE ISSUING INSURER WILL 86~FAY@R-Efd MAIL *3D DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT ffiXSMALb <br />H6PREBENi#iiVEBa <br />AUTHORIZED REPRESENTATIVE <br />