REP48210

AIDORD. CERTIFI TE OF
q
INSURANCE ` ° "6 ""�
6 / 24/92
JXIDDUOER
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
POLICIES BELOW.
THE SWALES AGENCY
COMPANIES AFFORDING COVERAGE
2860 S CIRCLE 12108
COLO SPGS CO 80906
COMPANY A
LETTER HAWKEYE SECURITY
.... .......... ...... ... .. .................. .......... ............ .
. ............................. ............................ ..... ... ....... ...............................
COMPANY
B
INSURED
LETTER
. ....... ......................................... ............................... . ........................ . .
. ......................
COMPANY C
AZCO CONSTRUCTION INC
LETTER
2055 HWY 50
COMPANY D
PENROSE CO 81240
LETTER
................................................. ............................... .
COMPANY E
LETTER
COVERAGES : ...... ..
...: .
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR
CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY 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. TYPE OF INSURANCE POLICY NUMEER
LTR
. POLICY EP ECTNE 'POLICY EXPIRATION
DATE (MMO YM DATE WMA)DNY) Ulm
Pi nPLSnu LIABILITY HAL204921311
11 /09/91 11/09/92 : GENERAL AGGREGATE {1 / 000,000
X COMMERCIAL GENERAL LIABILITY
.. ............ ........... ..
PRODUCTS{'OMROP AGO. S1 OOO, OOO
....' CLAIMS MADE X OCCUR..
............. ......
PERSONAL i ADP. PUURY . i 1 OO , O , O O O
OWNERS { CONTRACTORS PROT.
............. ....................... .. .... ...
EACH OCCURRENCE { 1 Q Q Q Q Q Q
/............ T.
........ .. .. ... .. .... ....................
.. .............. .. ... .. ..
... FIRE DAMAGE IARY .A. ti) ' {50,000
.............................
LED. EXPENSE (AN lRSWI t 0 00
AUMMO L1AElJTY
COMBINED SINGLE {
ANY AUTO -
: UMT
ALL OWNED AUTOS
: BODILY INJURY
.:........
SCHEDULED AUTOS
(Pr PALLOR) .
HIRED AUTOS
.......
... .......... ............................... ...... .
BODILY INJURY
NON-OWNED AUTOS
:.......
(PW .eudwM . {
GARAGE LIABILITY
.......
PROPERTY DAMAGE {
EXCESS LIABEJTY
EACH OCCURRENCE {
UMBRELLA FORM
:......
........................... .. ... ........................
AGGREGATE i
OTHER THAN UMBRELLA FORM
...... ..... .. ...............................
..:.. .. .. ..
WORKER'$ COMPENSATION
STATUTORY LIMITS .. .
MO ...........
EACH ACCIDENT {
.... ......
DISEASE-POLICY LIMB {
EMPLOYE" UMMLFTY
.. ............................... ..... .. ...............
DISEASE -EACH EMPLOYEE .3
OTHER
DESCAi110M OF OPERATKNI&lOGTKNOLVEHKIELSKCIAL ITEMS
ADDITIONAL INSURED STATE OF COLORADO
REFERENCE: POVERTY GULCH /GOLD HILL
CERTIFICATE HOLDER .: .; .: :.:
.CANCELLATION.
ADDITIONAL INSURED:
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
EDGAR T HUNTER
MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
PIKES PEAK MINING COMPANY
PO BOX 191
LEFT, BUT FAILURE TO MAIL SUCH NOTI HALL IMPOSE NO OSUGATION OR
ILITY OF ANY KIND UPON THE CO, A�T , ITS AGENTS OR REPRESENTATIVES.
VICTOR CO 80860
, REPRESE
=0.
2S3 (7/90)
C ACORD
((( /// CO FORA, H 1990
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