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IFICATE OF INSURANCE - 1VORKERS C01~7PENSATION 8r LIABILITY ONLY <br />III IIIIIIIIIIIII III is issued as a matter of information only and confers no rights upon the eertificnte holder. <br />999 foes not amend, extend or alter the coverage afforded by the policies listed below, <br />Project Description Be~Location:. Ryan Job No. 5712, Permit for Grassy., G~a~ Coal Mine <br />Ccrtificatc Holder: Colorado Department of Natural Resourc~Cand Reclamation Division, <br />Address: 1313 Sherman St. , Denver, CO 80203 <br />Architect: <br />Insured: Ryan Incorporated Central; Ryan Incorpdrated of Wisconsin, Box 206, Janesville, WI <br />Agent: Cobb, Strecker, Dunphy & Zimmermann, Inc. AddressP702 International Ln., Madison, WI <br />1VORKERS' <br />Policy No. WC 60 050 93 85 Effective Date 9/30/88 Expiration Date 9/30/89 <br />Insurance Company Transportation Insurance Company Address Milwaukee, Wisconsin <br />COVERAGE -Workers' Compensation, Statutory. Employers' Liability Llmlt <br />$1,000,OOOEech Accident $1,000,000. Disease Policy Limit $1,000,000. Disease Employee Limit <br />GENERAL LIABILITY <br />Policy No. GL 00 050 93 83 Effective Date 9/30/88 Expiration Date 9/30/89 <br />Insurance Company Transportation Insurance Company Address Milwaukee, Wisconsin <br />( )Claims Made (x) Occurrence ( )Owner's & Contractors Protective ( )Other: <br />LIMITS: <br />General Aggregate Limit (Other Than Products -Completed Operations) 51,000,000. <br />Products -Completed Operations Aggregate Limit 51,000,000. <br />Personal .& Advertising Injury Limit 51,000,000. <br />Each Occurrence Limit 51,000,000. <br />COVERAGE PROVIDED: YES/NO <br />Operations Of Contractor es <br />Operations Of Sub-Contractor(Contingent) yam, <br />Does Personal Injury Include <br />Claims Related To Employment? Yes <br />Completed Operations/Products Yes <br />Contractual Liability (Broad Form) Yg.~ <br />Exceptions: <br /> YES/NO <br />Govcrnmcntel Immunity Is Waived lid <br />Property Damage Liability Includes: <br />Damage Due To Blasting Yes <br />Damage Due To Collapse e~_s <br />Damage To Underground Facilities es <br />Broad Form Property Damage Ygg, <br />AUTOMOBILE LIABILITY <br />Policy No. BUA 40 50 93 86 Effective Date 9/30/88 Explratloa Date 9/30/89 <br />Insurance Company Transportation Insurance Company Address Milwaukee, Wisconsin <br />Any Auto (x) All Owned Autos (:Q Scheduled Autos (x) hired Autos (x) Non-Owned Autos <br />LIMITS: <br />Bodily Injury $ Each Person <br />5 Each Occurrence -OR- <br />Property Damage 5 Each Occurrcncc Combined Single Limit $1,000,000. Each Occurrence <br />UMBRELLA EXCESS Likl~il.iTY <br />Policy No. UMB 60 057 59 70 Effective Date 9/30/88 Expiration Date 9/30/89 <br />Insurance Company Continental Casualty Company Address Milwaukee, Wisconsin <br />LIMITS: <br />Single Limit Bodily Injury $5,000,000. Each Occurrence <br />And Property Damage $5,000,000. Aggregate <br />COVERAGE PROVIDED: <br />Applies in excess of the coverages listed above for Employers' Liability, General Liability, and Automobile <br />Llablltty. <br />Are any deductibles applicable to bodily injury or property damage on any of the above coveregesl No <br />If so, list. Amount 5 <br />AGENT CARRIES ERRORS AND OMISSIONS INSURANCEI YES <br />Should any of the above described policies be cancelled before the expiration date thereof, the issuing <br />company will mail 30 days written notJce to the parties to whom thiss ce~ate is issued <br />et~~t--~ Bison-r.l+F1~ cousin On 9/28/88 g M li, Jl' <br />~L~ <br />~ Y <br />'""` "~ ~c~ ~ Authoriz d Insurance Representative <br />SFP3U1988 <br />r,~ii~ro I_kNo <br />