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III IIIIIIIIIIIIIIII _ Jab ND. 5712 R~°~~,(~soy~ ggg -KATE OF_INSURANCE - WORKMEN'S COMPENSATION & LIABILI~iY ONLY //~~ ""'~lo' This certificate is issued as a matter nl information only alyd confers no rights upon the certificate holder. Tllis certificate doL~lA~am~~ne~ extend or alter the coverage afforded by the policies listed below. r~f~~4 JUO Permit for Grassy Creek Coal Mining Routt County, ColorO'd> q~.~ ~~~~Cr r;, Project Location +n.;~ !:- Owner Colorado Department of Natural Resources, Mined Land Reclamation Division, §+ilur~r.7u .•,bA Sherman St., Denver, CO 80203 '`~r~a;7 Contractor Architect/Engineer __ Insured Ryan Incorporated Central; Ryan Incorporated of Wisconsin, P.O. BOx 206, Janesville, WI53547 Agent Cobb, Strecker, Dunphy & Zimmermann, Inc. Address 2702 International Lane. Madison. WI 53704 WORKMEN'S COMPENSATION: Policy No. WC70 024 31 Effective 12/20/85 Expiration 12/20/86 Insurance Company Transportation Insurance Company Address Milwaukee, 4isconsin Coverage -Workmen's Compensation, Statutory. Employer's Liability Limit g100, 000/500,000/100,000. each accident PUBLIC LIABILITY: Policy No. CCP50 024 31 78 Effective 12/20/85 Expiraton 1:?/20/86 Insurance Company Transportation Insurance Company Address Milwaukee, l9i sconsin Type of Polity: Comprehensive ^Other LIMITS: Bodily Injury $ Each Occurrence Property Damage $ Each Occurrence $ Aggregate Personal Injury $ Aggregate COVERAGE PROVIDED (Check Applicable Square) Yes Operations Of Contractor Operations of Sub~Contractor (contingent) Does Personal Injury include claims related to employment? Completed Operations/Products Contractual Liability (broad loan) Exceptions: Aggregate - OR - Combined Single Limit $ 500, 000. Each Occurrence No Yes No ^ Governmental InimunilV Is waived ^ ^ Property Damage liability Includes Damage due to blasting ® ^ ^ Damage due to collapse ® ^ ^ Damage to underground facilities ~ ^ ^ Broad Form Property damage ^ ^ AUTOMOBILE LIABILITY: Policy No. BUA 30 024 31 79 Effective 12/20/85 Expiration 12/20/86 Insurance Company Transportation Insurance Company Address Milwaukee, Wisconsin Typo of Policy: Comprehensive ^Other LIMITS: Bodily Injury $ Each Person - OR - $ Each Occurrence Combined Single Limit $ 500,000. Each Occurrence Property Damage 5 Each Occurrence Yes No Coverage is provided for operation of all owned, hired and non owned vehicles © ^ UMBRELLA EXCESS LIABILITY INCLUDING AUTOMOBILE LIABILITY: Policy No. Effective Expiration Insurance Company Address LIMITS: Single Limit Bodily Injury and Property Damage $. _ Each Occurrence Ves No COVERAGE PROVIDED: Applies in excess of the coverages listed above for Employer's Liability. Public Liability and Automobile Liability SUBJECT TO THE TERMS OF THE POLICY. ^ ^ Are any deductibles applicable to bodily injury or property damage on any of the above coverages? If so, list. ^ Q AGENT CARRIES ERRORS AND OMISSIONS INSURANCE ^ ^ ~Yd't y of the above described policies be cancelled before the expiration date thereof, the issuing company will endeavor to mail 30 ]f ~ys written notice to the Ore'fdN(M~trslOtKcerti ficate holder, but failure to mail su h notice shall impose no obligation or (lability of any kind upon the company. Dated at Madison, Wisconsin pnJanuary 2,1986 B Aulhorlted Insurance Representative Construcr~on Industry Cooperative Comm~nee of M~nnesora - Form C I C.C.~701. Feb. 1961. Rev. June 1969, Rav. tan. 1971, R¢v. Nov. 1977 Prin red by R A. Ropers Co., 172J Wav rata Blvd , Mnls , 55405. X77 4670