GENERAL53379

• Permit No: C1980007
• IBM Index Class Name: General Documents
• Doc Date: 12/21/1998
• Doc Name: CERTIFICATE OF INSURANCE
• Permit Index Doc Type: INSURANCE
• Media Type: D
• Archive: No

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CERTIFICATE OF INSURANCE
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PRODUCER " THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
J&H MARSH & MCLENNAN, INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
777 SOUTH FIGUEROA STREET HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
LOS ANGELES, CALIFORNIA 90017 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
COMPANY
0659A=G2A2 A PACIFIC EMPLOYERS INSURANCE COMPANY
INSURED ,
COMPANY
ATLANTIC RICHFIELD COMPANY, ITS B

SUBSIDIARIES AND SUBSIDIARIES DEC 21 1996
THEREOF AS NOW OR HEREINAFTER COMPANY
CONSTITUTED C
515 SOUTH FLOWER STREET ~ ~- ~~• ~ •~/ MIOQf815 8 GBOIDQy COMPA
Y
LOS ANGELES, CALIFORNIA 90071 N
p
CO.VERAGE3
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 WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT 70 ALL THE TERMS.
IXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BV PAID CLAIMS.
CO
LTR TYPE OF INSURANCE POLICY NUMBER POGCV EFFECTIVE POIICV E%PIRATION LIMITS
DATE (MM/DOM1 DATE (MMIDDNII
A GEN ERAL LIABILITY HDO G7932476-A 01-Ot-99 01-01-02 BODILY INJURY OCC E NIA
X COMPREHENSIVE FORM BODILY INJURY AGG E N/A
X PREMISES/OPERATIONS PROPERTY DAMAGE OCC E N/A
X UNDERGROUND
E%PLOSION 8 COLLAPSE HAZARD PROPERtt DAMAGE AGG s N/A
X PRODUCTS/COMPLETED OPER BI8 PD COMBINED OCC S 2,000,000
X CONTRACTUAL BI B PD COMBINED AGG E2,000,000
X INDEPENDENT CONTPACTORS PERSONAL INJURY AGG E N/A
X BROAD FORM PROPERTY DAMAGE
X PERSONAL INJURY
A ADT DMGBILE LIABILITY ISA H0731754-2 01-01-99 01-01-02 BODILY INJURY

X
ANY AUTO
(Per perspnl E N/A
ALL OWNED AUTOS (Private Pass)
AIL OWNED AUTOS RODIIY INJURY
(Per accitlenl) E N/A
IOUIer than Private PassenDer)

HIRED AUTOS
PROPERTY pAMAGE E N/A
NON~OWNED AUTOS
GAPAGE LIABILITY BODILY INJURY N
PROPERTY DAMAGE E 2,000,000
COMBINED
E%CESS LIABILITY EAGH OCCURRENCE S
UMBRELLA FORM AGGREGATE S
OTHER THAN UMBRELLA FORM E
WORKERS COMPENSATION AND STATUTORY LIMITS
EMPLOYERS' LIABILITY
EACH ACCIDENT E
THE PROPRIETOP/
~PARI NERS/ExECU71VE INCL
- -
-' -
-- - pISEASE-POLICY LIMIT
-- S
-
OFFICERS ARE: E%CL DISEASE ~ EACH EMPLOYEE E
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITENS (LIMITS MAY HAVE BEEN REDUCED BY PAID CLAIMS AND MAV HAVE DEDUCTIBLES OR RETENTIONS)
*PRDDUCTS COMPLETED OPERATIONS.
CERTIFICATE ~HOL.DER.... ~;";. .....::::.. ;~~. ~............ ~ ':: CANCELLATION .
MINED LAND RECLAMATION DIVISION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
DEPARTMENT OF NATURAL RESOURCES E%PlgarloN DATE THEREOF. THE IBSUING COMPANY WILL ENDEAVOR TO MAIL
723 CENTENNIAL BUILDING 1O DAYS WRITTEN NOTICE TO THH^CERTIFICATE HOLDER NAMED TO THE LEFT,
1313 SHERMAN STREET BUT FAILURE TO MAIL EUC OTICE S ALl IMPOSE ND OBIt(LA NOR l1ABIlITY
DENVER, CO 80203 OF ANY KIND UPON HE COMP Y, ITS AGENT^/~OR REPq SENTATIVES.
AUTHORIZED REPRESENT IVE
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