GENERAL55117

• Permit No: C1984063
• IBM Index Class Name: General Documents
• Doc Date: 12/3/2001
• Doc Name: CERTIFICATE OF LIABILITY INSURANCE
• From: DMG
• To: EASTSIDE COAL CO INC
• Permit Index Doc Type: INSURANCE
• Media Type: D
• Archive: No

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STATE OF COLORADO
DIVISION OF MINERALS AND GEOLOGI'
Department o(Na[ural Resources
1313 Sherman S[., Room 215
Denver, Colorado 80203
Phone: [phone]
FAX: [phone]
December 3, 2001
Eastside Coal Company, Inc.
%a Stephen Self
1098 County Road 214
Silt, Colorado 81652
Subject: Certificate of Liability Insurance
Dear Mr. Self:
DIVISION OF
MINERALS
GEOLOGY
RECLAMATION
MIN ING•SAFETY
Bil I Owens
Governor
Greg E. Walther
EKecmive Dueaor
Michael B. Long
Division Director
Thank you for the copy of your.current Certificate of Liability Insurance (policy expiration date
09/O1L02)(a copy at Enclosure 1). However, Rule 2.03.9(3), cited below, and general guidance .
(see Colorado Mined Land Reclamation Division letter of January 8, 1992),. requires a change io
the standard language of ACORD CORPORATION form ACORD 25-5.
Rule 2.03.9(3) "The policy shall include a rider requiring that the insurer notify the Division .
whenever substantive changes are made in the policy, including any termination or. failure to
renew."
In addition, general guidance is to delete that portion of the ACORD 25-5 (7/97) form that reads";
but failure to do so shall impose no obligation or liability of any kind upon the insurer, its agents
or representatives"
Please submit a revised certificate in compliance with Rule 2.03.9(3) and this general guidance. A
copy of a correct version, your previous Certificate of Liability Insurance, is at Enclosure 2.
Please call me if you have any questions concerning this request.
Yours truly,
~1~ ,crir2 /j Gf/~
Byro~G. Walker
Environmental Protection Specialist
2 Enclosures, as stated
Cc: Dan Hernandez, CDMG
Files: C-84-063 Insurance Certificate
C:\W PDOCS\Eastside~nscertlt02r.pm.doc