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<br /> <br />ACORD,M CERTIFICATE OF LIABILITY INSURANCE 12/16/2010 <br />PRODUCER / <br />HUB International Ins Svcs Inc ? <br /> <br />2742 Crossroads Blvd THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Grand Junction, CO 81506 <br />970 245-8011 <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED INSURER A: Mountain States Mutual Casualty <br />Parkerson Construction, Inc. INSURER B: Pinnacol Assurance Company 41190 <br />710 S 15th Street INSURER C: <br />Grand Junction, CO 81501 INSURER D: <br /> INSURER E: CA Resident License # <br />COVERAGE5 <br />W HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />THE POLICIES OF INSURANCE LISTED BELO <br />N OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />ANY REQUIREMENT, TERM OR CONDITIO <br />RDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />MAY PERTAIN, THE INSURANCE AFFO <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> <br />NSR <br />DD' POLICY EFFECTIVE POLICY EXPIRATION LIMITS <br />LTR d <br />NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD DATE (MM/DDNYYY) <br /> 01101/2011 01/01/2012 EACH OCCURRENCE $1.000,000 <br />A GEN ERAL LIABILITY TO RENTED <br /> <br />ITY DAMAGE $100 000 <br /> X COMMERCIAL GENERAL LIABIL <br /> 51 MED EXP (Any one person) $10 000 - <br /> OCCUR <br />CLAIMS MADE PERSONAL & ADV INJURY $1,000,000 <br /> <br /> GENERAL AGGREGATE $2,000,000 <br /> <br /> ES PER <br />' PRODUCTS - COMP/OP AGG $2 000 000 <br /> : <br />L AGGREGATE LIMIT APPLI <br />GEN <br /> POLICY PROJECT LOG <br />A AUT OMOBILE LIABILITY 01/0112011 01/01/2012 COMBINED SINGLE LIMIT <br />id <br />t <br />E $1,??0,00() <br /> en <br />) <br />( <br />a acc <br /> X ANY AUTO <br /> ALL OWNED AUTOS BODILY INJURY <br />P $ <br /> er person) <br />( <br /> SCHEDULED AUTOS <br /> X HIREDAUTOS BODILY INJURY <br />id <br />t <br />P $' <br /> en <br />) <br />( <br />er acc <br /> X NON-OWNED AUTOS <br /> PROPERTY DAMAGE $ <br /> (Per accident) <br /> AUTO ONLY - EA ACCIDENT $ <br /> GA RAGE LIABILITY <br /> OTHER THAN EA ACC $ <br /> ANY AUTO AUTO ONLY: AGG $ <br />A 01/01/2011 01/01/2012 EACH OCCURRENCE s3,000-000 <br /> EXCESS/UMBRELLA LIABILITY <br />MS MADE <br />D AGGREGATE s3,000,000 <br /> CLAI <br />X OCCUR <br /> <br /> $ <br /> DEDUCTIBLE <br /> $ <br /> RETENTION $ <br />WORKERS COMPENSATION AND 01/01/2011 01/01/2012 <br />WC STATU- OTH- <br />X I 1R <br />H EMRL4WZRS-61ABtLIT1 - <br />E E.L. EACH ACCIDENT $500,000 <br /> ANY PROPRIETOR/PARTNER/EXECUTIV <br />MBHFR EXCLUDED? N <br />OFFICER/M? <br />N ) <br />M <br />t <br />E.L. DISEASE - EA EMPLOYEE <br />$500,000 <br /> n <br />( <br />ana <br /> <br /> describe under <br />E.L. DISEASE - POLICY LIMIT <br />$500,000 <br /> SPECIAL PROVISIONS below <br /> OTHER <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />#M-87-178, De avel Pit DEC .? 010 I/ <br />For Information Purposes Only. <br />Dhos" di RoewmeY". <br />IlugNiM ? ? <br />State of Colorado <br />Mined Land Reclamation Division <br />Dept of Natural Resources <br />1319 Sherman St Rm 215 <br />Denver, CO 80203 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _'AQ DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />AUTHORIZED EPd/,SES- c'I e?j <br /> <br />ACORD 25 (2009/01) 1 of 2 # V I <br />The ACORD name and logo are registered marks of ACORD SA02