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--------------------------------------------------------------------------------------------------------------- <br /> CERTIFICATE OF INSURANCE <br /> SUCH INSURANCE AS RESPECTS THE INTEREST OF THE CERTIFICATE HOLDER WILL NOT BE CANCELED OR OTHERI <br /> TERMINATED WITHOUT GIVING 10 DAYS PRIOR WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED BELOW, BUT ll� <br /> EVENT SHALL THIS CERTIFICATE BE VALID MORE THAN 30 DAYS FROM THE DATE WRITTEN. THIS CERTIFICATE OF INSURA <br /> DOES NOT CHANGE THE COVERAGE PROVIDED BY ANY POLICY DESCRIBED BELOW. <br /> This certifies that: STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY of Bloomington, Illinois,or <br /> STATE FARM FIRE AND CASUALTY COMPANY of Bloomington,Illinois <br /> has coverage in force for the following Named Insured as shown below: <br /> Named Insured FRICK, MICHAEL & MAXINE <br /> Address of Named Insured 1417 326 ROAD <br /> SILT, CQ 21652 <br /> POLICY NUMBER <br /> PENDING <br /> EFFECTIVE DATE <br /> OF POLICY 7 29 93 <br /> DESCRIPTION OF 90 FORD PU <br /> VEHICLE 1 GCDK142XLE143491 <br /> LIABILITY COVERAGE EZI YES Q NO Q YES Q NO Q YES Q NO Q YES 0 NO <br /> LIMITS OF LIABILITY <br /> a. Bodily Injury 1 ,000,000 <br /> Each Person <br /> Each Accident <br /> b. Property Damage <br /> Each Accident <br /> a Bo*h jury&Roperty <br /> Dwgp Single Ltrilt <br /> Each Accident <br /> PHYSICAL DAMAGE ®YES 0 NO Q YES Q NO Q YES 0 NO 0 YES Q NO <br /> COVERAGES <br /> aComprehensive $ Deductible $ Deducible $ Deductible $ Deductble <br /> YES Q NO 0 YES 0 NO Q YES 0 NO Q YES Q NO <br /> b. Collision $ Deductible $ Deducible S Deductble $ Deductible <br /> NON-OWNERSHIP 0 YES Q NO 0 YES Q NO Q YES Q NO 0 YES Q NO <br /> COVERAGE <br /> HIRED CAR CO GE 0 YES Q NO Q YES 0 NO 0 YES Q NO Q YES Q NO <br /> AGENT 1890 7/29/93 <br /> Signature of Authorized Representative Title Agent's Code Number Date <br /> Name and Address of Certificate Holder Name and Address of Agent <br /> f f <br /> STATE OF COLORADO <br /> DIVISION OF MINERALS AND GEOLOGY Rt , " <br /> 1313 SHERMAN ST. <br /> DENVER, CO AUG 6 1M <br /> DID.';'.^„ <br /> MINERALS :.":, <br /> L J L_ <br /> CERTIFICATE HOLDER COPY <br />