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JUL-18-,97 FRI 16:12 ID:DOLCOES PUBLIC LIBRA TEL NO:970 882 2224 #272 P02-.. <br /> 1"yomin"m M11 /111 <br /> POLICY INFORMATION PAGE <br /> FEBRUARY 25, 1997 <br /> POLICY NUMBER: 3528781 <br /> COLORADO <br /> COMPENSATION OWNERSHIP: PARTNERSHIP <br /> INSURANCE POLICY TYPE: ADVANCE <br /> ITEM 1. NAME AND ADDRESS OF INSURED <br /> GUYRENE WARD AND RAY M WARD DBA RAY <br /> r <br /> WARD TRUCKING <br /> 30183 HWY 194 <br /> DELORES CO 81323 <br /> J <br /> Yl <br /> LOCATIONS - ALL USUAL WORKPLACES OF THE INSURED AT OR FROM WHICH OPERATIONS COVERED:SY <br /> THIS POLICY ARE CONDUCTED A14D ARE LOCATED AT THE ABOVE ADDRESS UNLESS OTHERWISE STAkb. <br /> ITEM 2. POLICY PERIOD: 12 0014A A.M. MOUNTAIN STAND R s <br /> D TIME <br /> ITEM 3, A. WORKERS' <br /> ON LAW OF THE INSUR NCt:LIS P TONE OF THE POLICY APPLIES TO THE WORKERS' <br /> CO <br /> COLORADO <br /> g EMPLOYERS LIABILITY INSURANCE:PART TWO OF THE POLICY APPLIES TO WORK IN EACH STATE LISTED <br /> IN ITEM 3 A. THE LIMITS OF OUR LIABILITY UNDER PART TWO ARE: <br /> BODILY INJURY BY ACCIDENT $100,000 EACH ACCIDENT <br /> BODILY INJURY BY DISEASE $100,000 EACH EMPLOYEE <br /> BODILY INJURY BY DISEASE 5500,000 POLICY LIMIT <br /> C. OTHER STATES INSURANCE' PART THREE OF THE POLICY APPLIES TO THE STATES, IF ANY, LISTED HERE: <br /> NONE <br /> (CONTACT US FOR INFORMATION OUTSIDE THE STATE OF COLORADO) <br /> D- THIS POLICY INCLUDES TIME ATTACHED ENDORSEMENTS AND SCHEDULES: <br /> ITEM 4, THE PREMIUM FOR THIS POLICY WILL BE DETERMINED BY OUR MANUALS OF RULES, CLASSIFICATIONS, <br /> cTTO <br /> T. THE NG STATEMENTS INFORMATION <br /> STATE ENTS OFEST MATED ADVANCE PR PREMIUM VERIFICATION <br /> HEREBYBY MADE A <br /> BY AUDIT. <br /> PART OF THIS <br /> BY <br /> POLICY. <br /> Colorado CompOnsation Insurance Autho 'ty*720 S. Colo. Blvd_ Ste. 100-Ne Denver,CO 80222• (303) 782-400001-800-873-7 <br /> Colorado Business--Our Business Since 1915 UPDATED 8/% P401-01 <br />