GENERAL51862

• Permit No: C1981022
• IBM Index Class Name: General Documents
• Doc Date: 8/30/2002
• Doc Name: Certificate of Insurance
• Permit Index Doc Type: Insurance
• Media Type: D
• Archive: No

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PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Aon Risk Services, Inc of Florida ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
222 Lakeview Avenue HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Suite 510 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
West Palm Beach FL 33401 COMPANIES AFFORDING COVERAGE
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COMPANY Federallnsurance Company ,7C
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PHONE -{561) 253-2501 ' FAX - [phone] .
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INSURED C_`31~OZ COMPANY - Ali
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. ' -Oxbow Carbon & Minerals, Inc. n
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Donna
Gulbransen C
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West Palm Beach FL 33401-8101 USA fa~
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COMPANY
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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 4MTH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE 6EEN REDUCED BY PAID CLAIMS.
CO TYPE OF iN$URANCE POLICY NUMBER POLICY EFFECI7VE POLICY CXPIRATWN WMITS
L DATE (krM/DD/YYI DATE (MMlDD/YY)
A GENERAL LIABILITY 3710-0268 09101!02 09(01103 GENERAL AGGREGATE $2,DDD,OOD

~, COMMERCWL GENERAL LIABILITY General liability
PRODUCTS-COMP/OP AGG $1,000,000
CLAIMS MADE OCCUR PERSONALBADV INJURY $1,000,DOO
OWNER'S &CONTRACTOR'S PROT EACH OCCURRENCE $1,000,000
FIRE DAMAGElAnY One Ref $1DO,DOD
MED EXP (Arty one cersonl $10,000
A AU TOMOBILE LIABILITY 7307-72-58 09!01!02 09!01!03
COMBINED SINGLE LIMn
$1,000,000
X ANY AUTO Business Automobile

ALL O WNED AUTOS BODILY INJURY
.SCHEDULED AUTOS I Per Person! ~,
HIRED AUTOS - BODILY INJURY
NON-OWNED AUTOS _ (Per arc,dentl i
PROPERTY DAMAGE I
I
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT I
ANY AUTO OTHER THAN AUTO ONLY: I
EACH ACCIDENT I
AGGREGA7
EXCESS LIABILITY EACH OCCURRENCE
UM@RELLA FORM AGGREGATE
OTHER THAN UMBRELLA FORM ~~
_- _ . _. _ _ _.`. _ _ _ __ _ _ _ ___ _ WC STATU.
_OTH-
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WORKER'SCOMPENSATONAND _ _
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EMPLOYERS' LIABILITY EL EACH ACCIDENT
THE PROPRIETOR/
PARTNERSlEXECUTIVE INCL
EL DISEASE-POLICY LIMIT
OFFICERS AREt EXCL
EL DISEASE-EA EMPLOYEE

S CRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECUlL ITEMS
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SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE i
Miner) Land RBClamatlOD DIV. EXPIRATION OATS THEREOF, THE ISSUING COMPANY VMLL ENDEAVOR TO MAIL
1313 Sherman St, Room 215 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.
Denver CO 80203 USA @UT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO 0@LIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES.
AUTHORI2ED REPRESENTATIVE ~ /~/J
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