Laserfiche WebLink
t by: Jet Fax M930 42130; 07/20/00 9:45AM;JetF1x #968;Page 1 /1 <br /> Certificate of Insurance 7 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE <br /> IS NOT AN INSURANCE POLICY AND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED. <br /> Liberty <br /> This is to Certify that <br /> Northwest <br /> BITTERROOT RESTORATION INC <br /> 445 QUAST LN P O Box 5240 <br /> CORVALL IS MT 59828-9406 Portland, OR 97208-5240 <br /> 11111111111111111111111111111111111illlllllllllllllllllllllllltl 503.239.5800 <br /> is, at the date of the certificate, insured by iris Company under tho policr(ies) listed below. The insurance afforded by the listed policy(leO Is <br /> subject to all their terms,exclusions and conditions and 15 not altered by any requirement, term or condition of any contract or other document <br /> with respect t:k which this certificate may be issued. <br /> EXPIRATION — <br /> TYPE OF POLICY DATE POLICY NUMBER LIMITS OF LIABILITY <br /> COVERAGE AFFORDED uNOER w.c. taw LIMIT OF LIABIUTy - COVERAGE A <br /> OF FOLLOWING STATES <br /> X WORKERS, 8.1. by Each <br /> Accident $500,000 Accident <br /> COMPENSATION 1/01/2001 WC4-1NC-007790 MT 5,1. by Policy <br /> Disease $500,DOOLfmit <br /> B.I. by Each <br /> Disease $500,OOOEmployse <br /> TIME COVERAGE-FOLLOWING STATES LIMIT OF LIAB.-MARITIME COVERAGE <br /> GENERAL LIABILITY General Aggregate S <br /> Commercial General Prodaers Conp/aPS Aggregate S <br /> Liabllrty (Occurrence) I Personal & Advertising Injury S <br /> Owner's end I Each Occurrence g <br /> Comractor's Protective I Fire Damage (Any one fire) g <br /> u Medical Expense (Any one person) g �� <br /> !-1 AUTOMOBILE LIABILITY <br /> ❑ Any Auto CSL S <br /> ❑ All owned Aulos Bodily Injury (Per Person) S <br /> ❑ Schedoled Auloa <br /> Do4i1y Injury (Per Accident) 5 <br /> ❑ Rlred Autos <br /> Property DeMege S <br /> ❑ Non-owned Autos <br /> ❑ Garage 11shillly ! <br /> � OTHER i <br /> t <br /> LOCATIDN(S) OF OPERATIONS & i0a F (IF APPLICABLE) DESCRIPTION 11 OPERATIONS <br /> ALL OPERATIONS OF INSURED <br /> **FAX (303) 932-8106 <br /> � I CANCELLATION: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING _ <br /> COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED BELOW, BUT <br /> FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABIL OF ANY KIND UPON THE COMPANY, OR <br /> REPRESENTATIVES. 1 <br /> MAILED TO- STATE OF COLORADO, DEPT OF NATURAL RESOD t <br /> DIV OF MINERALS & GEOLOGY <br /> ATTN: YVONNE BRANNON <br /> 1313 SHE:RMIAN ST STE 215 � <br /> DENVER CO 80203-2243 EFS ss 7/20/2000 MISSOULA Markating <br /> IInI111un1lalllnn111u111L1!►IIInIlallnlln1111►1h111 - <br /> DATE ISSUED OFFICE <br /> L <br />