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III IIIIIIIIIIIII III s/~, App~,ndi n~ d To. Mined LandoReclamation Divisioi <br />999 epar men o a ura ecource: <br />DocDate:12H1/2001 Date: June 24, 1991 <br />INSDRANCE BTATEMENT <br />KNOW ALL MEN BY THESE PRESENTS: K N Energy, Inc., a Kansas corporation, <br />and any wholly-owned subsidiary interests (including Slurco Corporation and <br />the Canadian Strip Mine) as are now constituted or which may hereafter be <br />constituted, (collectively referred to as "K N") have in force workers' <br />compensation, public liability and property damage and automobile insurance <br />coverages with the limits as detailed below: <br />1. Workers' Comuensation and Employers' Liability - K N is self- <br />insured up to $250,000 for workers' compensation and <br />employer's liability in the States of Kansas, Nebraska, <br />Oklahoma and Wyoming for those employees not covered by state <br />fund. In Wyoming, K N participates in the qualifying state <br />fund to the extent possible. In all other states where K N <br />does business, it maintains such insurance in the maximum <br />amounts required by law. An excess policy is maintained for <br />amounts in excess of the self-insurance retention and maximum <br />amounts required by various state statutes. <br />2. Third Party Public Liability and Property DaIDaae - K N self- <br />insures for the first $250,000 in public liability and <br />property damage and maintains coverage in excess of the self- <br />insured retention for third party liability and property <br />• damage claims under various policies. Such coverage exceeds <br />$1,000,000. <br />3. Automobile- Public Liability and Property Damage - K N <br />maintains automobile public liability insurance of $1,000,000 <br />combined single limit bodily injury and property damage each <br />occurrence and uninsured motorist protection with Royal Globe <br />Insurance Companies and Progressive Casualty Insurance <br />Company. <br />The above coverages are currently effective with varying policy terms. <br />K N will endeavor to provide 30 days' written notice in the event of any <br />material adverse changes or alterations to such coverage. <br />CERTIFICATION <br />i hereby certily that the above is a true and correct statement covering <br />the insurance in force by 1C N Energy, inc., including its aubaidiaries, as of <br />January 1, 1991. <br />Rich. Buxton <br />Director of Insurance <br />• This Insurance Statement is being furnished with the understanding that <br />the information will be held in confidence by the recipient. <br />K N's insurance broker is Alexander and Alexanpder,/' JaIInc., Lincoln, <br />~VGtMyFe~ o'r f~''"'~~ lZ~ja/!?/ <br />