GENERAL55215

• Permit No: C1980003
• IBM Index Class Name: General Documents
• Doc Date: 7/6/2001
• Doc Name: CERTIFICATE OF INSURANCE
• Permit Index Doc Type: INSURANCE
• Media Type: D
• Archive: No

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NO flIGNTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IM TXE
7166 Avenue of Amerips POLICY. TNIS CERTIFICATE GOES MOT AMEND, E%TEND OR ALTER TXE COVERAGE
411h FIOOr AFFORDED BY THE POLICIES DESCRIBED NEREIN.
New York, NY 10036 COMPANIES AFFORDING COVERAGE
COMPANY
08046-AIlxs-xs-01-02 p A Evanston Inwrance Company
INSURED COMPANY
H-G Coal Company B HARTFORD FIRE INSURANCE CO.
c/o W.R. Grace 8 CD. ~~~ p g 2001
7500 Grace Drive
COMPANY
Columbia, MD 21044 C HARTFORD INSURANCE CO OF MW
n of Minerals b Geolo9Y
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COVERAGES ~~Thls dertlfi.CaS@S4parsedes and FeplaceS ORY PreyiO:USJy issued~~~eHlfigte fDf;lhe poflLy peF.lgd ngtelj pelCW .. ,~?.. .: :.
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED
NOTw1TNSTANDING ANV REOUIREMENi, TERM OR CANDITION OF ANY CONrRACT OR OTNER DOCUMENT MATH RESPECT TO NHICH THE CERTIFICATE MAV BE ISSUED OR MAV
PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. CONDITIONS AND EXCLUSIONS OF SUCH POLICIES LIMITS SHONN
MAY HAVE BEEN REDUCED BY PAID CW MS
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LTR TYPE OF INSURANCE POLICY MUYBER POLILT EFFECTIVE
OATS tYYIDDIYYI POLICY EXPIRATION
GATE tYMIDDIYY) LIYITS
A GEN ERAL UA&LITY 01GLP1005479 D6/30/D1 U6/30/D2 GENERAL AGGREGATE j 2,OOD,D00
x COMMERCIAL GENERAL LIABILRV PRODUCTS-COMPAJP AGG S 2~~~~~00
CLAIMS MADE OCCUR PERSONALb ADVINJURY S 2,000,000
ONMER'S bCONTRACTOR'S PROT EACH OCCURRENCE S 2~00~~~00
FIRE DAMAGE (Myone Rre) S
MED EXP M me ram S
B AU T OMOBILE LIABILITY 10ABRC47901 (All Other) 06I3D/01 D6(JD/D2 COMBINED SINGLE LIMIT j 2,000,p00
C X ANY AUTO 10ABRC47903 (TX) 06(30/01 06/30/02
ALL OWNED AVros 10MCPC47902 (MA) 06/30/01 06/30/02 BODILY INJURY j
(Par parson)
SCHEDULED AUTOS

HIRED AUTOS BODILY INJURY S
(Per a¢EenU
NON~OWNEO AUTOS
PROPERTY DAMAGE j

GARAGE LIABILITY
AUTO ONLY-EA ALCIOEM
S

ANV AUTO
OTHER THAN AUTO ONLY: . . . .....................

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EACH ACCIDENT 5
AGGREGATE S
E%CESS LIABILITY EACH OCCURRENCE S
UMBRELLA FORM AGGREGATE E
OTHER THAN UMBRELU FORM S
C WOPNEfl6 COU ENaATIOX AaO
EM PLOYERS'LIABILITY 1o~va~c47^.:c D6/3D/D1 D6l3D/D2 X TORY LIMBS ER

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EL EACH ALLIDEM j
2,Q00,000
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THE PROPRIETOR/ INLL EL DISEASE~POLICV LIMIT S S,000,OOO
PARTNERSE%ECUTIVE
DISEASE
EACH EMPLOYEE
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000
000
S 2
OFFICERS ARE: EXLL -
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DESCRIPTION OF OPEflATIOM3ILOCATION SlVEHICLE613PECIAL ITEYS (LIMITS MAY BE SUBJECT TO DEOULRBLES OR RETENTIONS)
The coverage and limits stated above apply to Permit pC80-003
The General Liability policy is excess of a 5500,000 self insured retention.
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91WUJ ANY OF THE fOl1CIE5 DESCRIBED HEREN 0E CANCELLED BEFORE THE U.PMTION MTE TIEREOF,
TIE NAIRER AfTORDING COVEMGE WLL L~IttA AMIL ~fl MYS NARFEN NOTCE TO THE
Colorado Division of Minerals and CERTIFICATE HOLDER NAMED NEREN,YIII{)D)CRSCYIAIYeFLG]fKYAAYiYlaCCeNrYNfAi
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Attn: Jim Stark "
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BleLmao7Cffi7t°76o[~faE7moTeucl9MFRx~1vnF.R.,• nF'Frcs"y~gxgy~pE+a
1313 Sherman Street -Room 215
Denver, CO 80203 MAftSN USA IMC.
ar: John J. Lyons ~i1"'p~b'o"~
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