PERMFILE139043

• Permit No: C1980005
• IBM Index Class Name: Permit File
• Doc Date: 12/11/2001
• Doc Name: INSURANCE CERTIFICATE
• Section_Exhibit Name: TAB 03 ATTACHMENT 3-10
• Media Type: D
• Archive: No

Aa:~n;~~. CERTIFICATE OF INSURANCE
ISSUE DATE IMMIDDIYY)
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PaooucER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
SEDGWT_CK. JAMES NATIONAL ACCOUNTS G I_Fib[ICIES BELOW.
°30 MORFIS TUkN'riNE

-IORT HILLS
NJ 07073 COMPANIES AFFORDING COVERAGE
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COMPANY
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LETTER
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INSURED . COMPANY B
LETTER L/ ~Iy J.~ _.
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STF.EET. SUITE 71111 LETTER

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COVERAGES _: ~._~:.. ._.:... ._:.~..:_.=:"_:~,._._:~,.a.~,..~.:.: ~...:.-.::..-, ,...a~..:....:3...:_~:.:~,::::~ ... .. ..._.__... _..._._......_..
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW NAVE BEEN ISSUED 70 THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANV CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY SE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
'LTA TYPE OF INSURANCE POLICY NUMBED POLICY EFFECTIVE POLICY E%PIRATION
DATE IMMIDDIYY) DATE IMM/DDIYYI LIMITS
GENERAL LIABILITY GENERAL AGGREGATE E 2 . 1] Q 1 101] 1 : I
r7 .{ COMMERCIAL GENERAL LIABILITY GL S 21] ~ 13 SI 11]' I) ~ ~ G ~ 1 Q ~ Q i ~ :.I ~ PRODUCTS-COMPIOP AGG. E (, f] 1 111 , Q 1] l,l
CLAIMS MADFX{ OCCUR. PERSONAL BADV. INJURY E1(1111]1]~;I]
OWNER'S 8 CONTRACTOR'S PROT. EACH OCCURRENCE E ~ 1]IJ IJ I)11!J '
]{F.+1^pf3~ Form V?RCjO1:';i (; t)VP~~QG 1t:C Ll1C~2C:. FIRE DAMAGE IAnY ane tire) E ~I)1)L~I: ,
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... __.... ... ... _ _ . .......
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MED. EXPENBE (Any one pemnl E _ 1)111 1
AUTOMOBILE LIABILITY COMBINED SINGLE E i
A a _ANY AUTO CA 1429040 10/O1 /:~:: i0/O1/l3 uMIT 1.Ijfn),nllli ~
:{ ALL OWNED AUTOS
__
BODILY INJURY E
:t SCHEDULED AUTOS IPer pereanl
}._ HIRED AUTOS GODLY INJURY
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S ~~
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~{ NON.OWNED AUTOS -
-
lPe~ acn0em)
I
GARAGE LIABILITY I
PROPERTY DAMAGE E
E%CESS LIABILITY EACH OCCJRRENCE 5
UMBRELLA FORM AGGREGATE E
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION STATUTORY LIMITS
. - __ .. __. ...__..... 1
EACH ACCIDENT
S
ANO _ _ _
. _.-,_ .._ _
DISEASE-POLICY LIMIT E
EMPLOYERS'LIABILITY ._. ..... .. ... .. _...._. _ ... I
DISEASE-EACH EMPLOYEE E
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS '..DYERS Vl]~TiRT =!'1J~ AT .`.EIJECA I_ ~'IIiV t,
NCL'JDING DP.MAGE FROM SURFACE CURL MINE Cc'RATT_IJNS. T'r'E USE I:F E:{Fr~._SI~iuS ADTD
DAMAGE TO WATER WELLS.
L
CERTIFICATE HOLDER . ,_ ~ .._ ., _ _ .
ti:LORADO DEH.43TMENT ~=~F !~A.TURAL
D.V. OF MT_NED L~.tJD RECL';MATION
~ C'ENTEi1NIRL ELVD
~f:h~.;aAiJ TREET
Denver, CO 80203
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE '.
EXPIRATION DATE THEREOF. THE ISSUING COMPANY WIC!// / / / ~I/ / /T.O/
RESuUi:MAIL'~ I___ DAYS WRITTEN NOTICE TO THE CERTIFICATE HO/L/DER NAMED TO TH/E I
LEFT, 9UT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR I
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. I
AUTHORIZED REPRESENT ~~
ACORD 25•S (7/90) Cs9ACORD CORPORATION 1990 I