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ACORD CERTIFICATE OF LIABI LITY INSURANCE OPID °ATE(MM/DD/Y"' <br /> EMCO-1 05/25/05 <br />PRODUCER <br />G ON <br />( <br />O <br />`' <br />G ONLY AND <br />CONFERS NO R GHTS UPON THE CER IFICATE <br />Blanchard Insurance Group Inc . (`~ ~~ v ~ <br />o.. ~ <br />y(c~ <br />G <br />P.O. Box 60130 <br />~ <br />~ HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />~ <br />~ <br />Grand Junction CO 81506 <br />' <br />~ <br />-J <br />• <br />~ <br />, <br />970 <br />Ph <br />245 <br />6011 <br />24 <br />~ <br />0 INSURERS AFFORDING COVERAGE <br />one: <br />- <br />- <br />Fax:97 <br />. <br />- <br />5- ~DgV <br />TD~58B <br />INSURED Mp <br />a INSU <br />A' Rt[g>loyera Nutual Casualty Co. <br />dG <br />L^C <br />~~c <br />isaR <br />D~ RER B <br />mece <br />Lv~sL <br />SEM Coastructipa CO. <br />~~ <br />¢¢ppe ef~ INSURER C: <br />~ <br />WW <br />715 ROr1ZOII Dr1Ve~ $111tF1nr1(9 - INSURER D: <br />Grand Junction CO 81506 <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 />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITN RESPECT TO WHICH THIS CERTIFICATE MAV BE ISSUED OR <br />MAV PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAV HAVE BEEN REDUCED BV PAID CLAIMS. <br />LTR TYPE OF INSURANCE POLICY NUMBER DATE MMID DATE MMrDD/YV LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1 i D O D ~ OOO <br />A X COMMERCIALGENERAL LIABILITY 9X90868 05/10/05 05/10/06 FIRE DAMAGE(Any one fire) S10U~ODU <br /> CLAIMS MADE ~ OCCUR MED EXP (Any one person) E 5 ~ 00 D <br /> PERSONAL BADV INJURY E1, OOO~OOO <br /> GENERAL AGGREGATE $2~000~000 <br /> GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS~COMP/OP AGG $2, 000000 <br /> POLICY PRO LOC <br />JECT <br /> AUT OMOBILE LIAe1LITY <br />COMBINED SINGLE LIMIT <br />EliDDD <br />DDD <br />A X ANVAUTO 9X90868 DS~1D~D5 DS~1D~Q6 (Ea aceidenq ~ <br /> ALL OW NED AUTOS <br />BODILY INJURY <br />E <br /> SCHEDULED AUTOS (Per person) <br /> X NIRED AUTOS <br />BODILY INJURY <br />$ <br /> X NON~OWNEO AUTOS (Par aa~dant) <br /> PROPERTY DAMAGE <br /> <br />(Per axitleni) $ <br /> GA RAGE LIABILRY AUTO ONLY ~ EA ACCIDENT E <br /> ANV AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS LIABILITY EACH OCCURRENCE E <br /> <br /> OCCUR ~ CLAIMS MADE AGGREGATE S <br /> a <br /> DEDUCTIBLE $ <br /> RETENTION E E <br /> WORKERS COMPENSATION AND <br />' TORY LIMITS ER <br /> EMPLOYERS <br />LIABILITY <br />_ - _^ __ <br />~_ -_ _~ _ E.L EACH ACCIDENT $ <br /> _ _ _~ _ E.L. DISEASE ~ EA EMPLOYE $ <br /> E.L. DISEASE-POLICY LIMIT $ <br /> OTHER <br />DESCRIPTION OF OPERATIONS.20CATIONBIVEHICLESIE%CLUSIONE ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />Re: North Thampaon Creek-File No C-81-025. State OE Colorado, Division Of <br />Ninarals & Geology is included as an Adflitional Insured.*10 Days Notice due <br />to Non-Payment Of Premium.**Or incur substantive changes or failure to <br />renew. <br />CERTIFICATE HOLDER N ADDITIONAL INSURED; INSURER LETTER: _ CANCELLATION <br />OOOOOO D SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />Stat6 Of COlOradO DATE THEREOF,THE lSSU1NG INSURER WILL ENDEAVOR TO MlLLL *30 DAYS WRITTEN <br />D.1V1930n Of Minerals Ge010gy NOTICE TO THE CERTIFlCATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />1313 Sherman Street ROOM 215 IMPDSE NO OBLIGATION OR LIABILITY OF ANV KIND UPON THE INSURER, ITS AGENTS OR <br />Denver CO 80203 <br />REPRESENTATIVES. - / i > <br />25-S (7/97) " - - ~ ®ACORD CORPORATION 1988 <br />