1996-01-26_GENERAL DOCUMENTS - C1981017

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CERTIFICATE OF INSURANCE ISSUE DATE 07/24/95 PRODUCER I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS Frost McGahey Insurance, Inc. NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, P.O. Box 8410 EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 235 South Ridge Street Breckenridge, CO 80424 COMPANIES AFFORDING COVERAGE COMPANY LETTER A: UNION INSURANCE COMPANY COMPANY LETTER B: INSURED COMPANY LETTER C: Ray Ward Trucking, Ray Ward and Guyrene Ward dba 30193 Highway 84 COMPANY LETTER D: Dolores, CO 81323 COMPANY LETTER E: COVERAGES THIS IS TO CERTIFY THAT 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 POL. EFF. POL. EXP. LTRI TYPE OF INSURANCE POLICY NUMBER DATE DATE LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ 11000,000 A I [X] COMMERCIAL GENERAL LIABILITY UPK5023812 04/01/95 04/01/96 1 PRODUCT-COMP/OPS AGG. $ 11000,000 [ ) CLAIMS MADE [X] OCCUR. I I PERSONAL & ADV. INJURY $ 1,000,000 � [ ] OWNER'S & CONTRACTOR'S PROT.1 EACH OCCURRENCE $ 11000,000 � [ ] FIRE DAMAGE (Any one fire) $ 50,000 MED. EXPENSE (Any one person)$ 5,000 r AUTOMOBILE LIABILITY � [ ) ANY AUTO COMBINED SINGLE LIMIT $ � [ ] ALL OWNED AUTOS � [ ] SCHEDULED AUTOS BODILY INJURY (Per person) $ [ ] HIRED AUTOS � [ ] NON-OWNED AUTOS I BODILY INJURY (Per Accident) $ � I ] GARAGE LIABILITY � [ ] PROPERTY DAMAGE $ i EXCESS LIABILITY 1 [ ] UMBRELLA FORM EACH OCCURENCE $ 1 [ ] OTHER THAN UMBRELLA FORM AGGREGATE $ WORKER'S COMPENSATION STATUTORY LIMITS AND EACH ACCIDENT $ DISEASE-POLICY LIMIT $ EMPLOYER'S LIABILITY DISEASE-EACH EMPLOYEE $ OTHER $ $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS CERTIFICATE HOLDER NAMED AS ADDITIONAL INSURED IN REGARDS TO THE COAL BASIN MINE 4 RECLAMATION PROJECT FORM B TO FOLLOW CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF JANY KIND UPON THE COMPANY, ITS GENTS 0 REPRESENTATIVES. STATE OF COLORADO AUTHORIZED REPRE T VE 1313 SHERMAN ST, RM 215 DENVER, CO 80203 FORM 25-S (7/90)