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19920721/1974410 IP247 /001 <br /> CERTIFICATE OF INSURANCE <br /> issued by the <br /> COLORADO COMPENSATION INSURANCE AUTHORITY <br /> 720 South Colorado Blvd, Denver, Colorado 80222, (303) 782-4000 <br /> CERTIFICATE HOLDER: <br /> MINED LAND RECLAIMATION <br /> ATTN MAGGIE VAN CLEEF <br /> 1313 SHERMAN ST RM 215 <br /> DENVER CO 80203 <br /> TO WHOM IT MAY CONCERN: <br /> This is to certify that this company has issued a Standard Workers' Compensation and Employers' <br /> Liability Policy as described below covering the liability imposed upon subject employers by the <br /> Workers' Compensation Act of Colorado, said policy being in good standing as of this date. <br /> POLICY NUMBER: 187841-0 07/21/1992 <br /> POLICY PERIOD: 07/01/1992 TO 07/01/1993 <br /> INSURED: AZCO CONST INC <br /> 1019 K STREET <br /> PENROSE CO 81240 <br /> ORIGINAL EFFECTIVE DATE: 08/13/1986 <br /> (" SEE BACK OF CERTIFICATE FOR CLASS COVERAGE AND OWNERSHIP COVERAGE DETAIL ") <br /> IMPORTANT:. THE COVERAGE DESCRIBED ABOVE IS IN EFFECT AS OF THE ISSUE DATE OF THIS CERTIFICATE. IT IS <br /> SUBJECT TO CHANGE AT ANY TIME IN THE FUTURE. <br /> All policies are subject to the following provision of the Workers' Compensation Act with respect to <br /> cancellation: <br /> Section 8-45-113. If any employer shall be in arrears for more than thirty days in any payment required <br /> to be made by him to the Colorado Compensation Insurance Authority as provided by this Act, he <br /> shall by virtue of such arrearage be in default of such payment and any policy issued to him by said <br /> Authority shall thereupon be cancelled without notice as of the effective date or renewal date of said <br /> policy. <br /> COLORADO COMPENSATION INSURANCE AUTHORITY <br /> JENNIFER L NUNOE C.A.U. REP I (SOS)792-4010 <br />