|
04/11/95 16:25 W03 242 1894 Valley Agency 0001
<br /> ...is •�.. M.
<br /> Ao.:Y.= . -0!Cn>"�'>iTiY•L:'.n�n'r:C<.?`��„��,"' •y,,r y,
<br /> ���,t�t, ` C(yh h'K An hl rei (4♦` i1Ya�"i?t+:Cl:.� :'.X:.....
<br /> r
<br /> DATE nn,^
<br /> <
<br /> PRPRODUCER ... .:.. ....- ... ....... ... <':..r"" ... +.e:' �x�•� "r..i...:................YM.._/va-.........--........THIS CERTIFICATE I8 ISSUED AS A MATTER OF INFORMATION ONLY AND
<br /> CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER- THIS CERTIRCATE
<br /> Va116y /naaranee Agency ' DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
<br /> 604 25 Road POLICIES...BELOW.
<br /> ..............................
<br /> ..........................................
<br /> Grand dunct/on CO 81502 COMPANIES AFFORDING COVERAGE
<br /> ........I...................
<br /> ANY ............. ............................... .
<br /> COM
<br /> .....
<br /> ................
<br /> LETTe .......A GLOBE INDEMNt"
<br /> • COMPANY ...
<br /> Lem
<br /> . Post-It"" brand fax transmittal memo 7671 xolpegea
<br /> Kewlers howamatlen rOWPnxr To From
<br /> EaRfunewin0 Co FIR
<br /> P.O. SON 41 Ca
<br /> Rockra/e CO 81244 LETTER Dept. 0-- rj s.
<br /> COMPANY
<br /> Phone N
<br /> COMPANY
<br /> ••;:aa a>sz. �:a<:Y,>:,: LETTER
<br /> •w�,•n,•>»r�:. " ,•f�c.;'^:b`.G:>':��•:.y,rst.�s�.�.}.'�;Y�.r'«3isaroe:.a.2•y3s.- �• '!;. �;.-.:� x;;�.�_;,f;{:,,�'�t.r.'•.3:.•':'''y�''-^'�>t� ,
<br /> •.x •.,•�.*toe.K.v:ar•.::u»:«eor':.::......•...—..•..•.w:.,,,-._..:.................... ..
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BED
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDIItOLW N OFHAVE ANYBEEN CONTRAISSUEDC TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> T OR OTHER DOCUMENT WITH RGSPECT TO WHICH THIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS-
<br /> ...... ;............. .. .... . ...........�.. .............
<br /> CO
<br /> ............
<br /> LTR TYPE OF NSURANCE POLICY NUrt�R POLICY EFFECTIVE :POLICY EXPIRATION
<br /> ............... i OATS (NWDDNn DATE(6NAIppfM LAM............. .............
<br /> ...... ...............
<br /> A >GHAE3IAL UABIL fY Gs"192200004 = 12106/Da .......'...03/a6.....
<br /> GBGRAL AGGREGATE t 2000000 COI.QMGiCWL GENETIAI' LfABL,R1'
<br /> at4.......: _ PROOIJCfS.COMPIOP AGO..... .rs.................. ...-.....
<br /> ;OCCUR. ; i ..... . .. ..........CIAaeS MARE 2000000
<br /> PERSON&a ADV.WAM 00000
<br /> OWNERS 6 CONIRACTDRB PROT. ? ....................
<br /> EACn ocGURRENCE :s 10000
<br /> r.....,..°......_...........................
<br /> >...... 00
<br /> ......
<br /> FTtIE DAMAGE(Any one Are) :t 50000
<br /> ..a..... ................ .............. .....
<br /> ..............
<br /> A iAUTgpB�LIABBITy 06� .............. oo..
<br /> t...
<br /> . GSP21ISSM089 >rw 120
<br /> M(;D EAPFI+sE(aI.
<br /> ny w Pe.eon, .r5o
<br /> 6/D6 coMell�sENGIE
<br /> :ANY AUTO LBArr s 600000
<br /> ALL OWNED AUTOS ?.................. ...............;...................
<br /> ;...._.. ...........
<br /> Z SCK2RULED AUTOS . BODILY DWRY
<br /> (Par person)
<br /> x ;HIRED AUTOS `
<br /> ................. ...........
<br /> 1.
<br /> BODILY NJURY
<br /> Y ;NON-OWNED AUTOS i(Pef ettleenQ �:
<br /> GARAGE LIABILITY
<br /> .............................
<br /> ........:.....
<br /> PR OPERiT DAMAGE
<br /> S
<br /> EACH OCCURRENCE
<br /> .............
<br /> UMBRELLA a
<br /> 01H6T THAN UMBRELLA FORM :'AGGREGATE ;
<br /> ..................................................
<br /> :.»
<br /> WORKEFM COMPENSATION i STATUTORY LIMITS {'
<br /> AND :EACH E>`.- ...:...
<br /> ACCIDENT
<br /> ...................
<br /> ;...
<br /> OAPiOYEAa'LIABLITY ;OISEASE-POLICY LGWT S
<br /> . ..Ehul.OYEE
<br /> .................
<br /> •QTFIEi ...............
<br /> Of5FJL9E EACH
<br /> ' ;
<br /> .................
<br /> .......
<br /> DF.SCRIRTION OF oPHiATC*dSL CATK)NSMtli yIL R•EMS
<br /> 0 eredo Division of Minerals and Geology is shown as an AdditionaL Insured
<br /> � Ogg 'aen,
<br /> ., —4ff'A'�2la:waat..<LT..,...::.�.�� :i:L'•�;;.�..�.s.>.< K:j•y >:s..�<�fst° .,.Y.x',K�i•�:; �
<br /> '+w'a.•.Y:;,.. >. A ... ��x:.k:Y i x`i�':: � � .•r.F .` a�.�. x•��g. .yf'iie::�is;xi`Li��<�
<br /> ^i SHOULD ANY OF THE AB "`ri `;E; a... .t` L:i a2`iii:S.:=: x;.x>,>}sKx>'«•,
<br /> OVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br /> ?Y=> EXPIRATION DATE THEREOF.THE ISSUING COMPANY WILL ENDEAVOR TO
<br /> Colorado aIr., or Mineralss o.eraay
<br /> MAIL t0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
<br /> ATM: Ma"jo, vas pow >`.
<br /> %> LEFT, BUT FAILURE TO.MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGAT1pN OR
<br /> t912 Sherman Street, Room2i3
<br /> Denver CO 80309 LIABILITY OF ANY IGND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
<br /> F ulTF10R�D REPRESENTATIVE
<br /> :TICS:
<br /> •�7;"�xlT :tfilt•k*;ZYP�.,at`:ia�v'>ipY"iy. ,.xf:..x'l�i"..K'�'•• '•:'(S>eiY„;"' '3slF w� .�A +nkx S>»i�
<br /> a7..:an k t��°; ,r c>za .es, 3' y`. .s= `s <:
<br /> :<Lxe�>::. s-r�"S;?xY••,`v. .�,% ,.. rY..,�.< y,�
<br /> �''S,.',YoySb s:> EYh: � r>,<'�'.u�::ik•:sS,e':<:i:•Yr3::S:Cf.'•iYy->` ».<,f .!t u�:++< Y''o
<br /> � oa
<br />
|