1995-09-21_GENERAL DOCUMENTS - C1981017

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4-29-1996 8: 17AM FROM FROST MCGAHEY INS. 970 453 5935 P. 1 CERTIFICATE OF INSURANCE ISSUE DATE 04/25/96 PRODUCER I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS Frost McGahey Inausance, Inc. I NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND, P.O. Box 8410 f EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Z35 South Ridge Street Breckenridge, CO 80424 ) COMPANIES AFFORDING COVERAGE COMPANY LETTER A: UNION INSURANCE COMPANY I COMPANY LETTER B.- INSURED I COMPANY LETTER C: Ray Ward Trucking, Ray Ward and Guyrene Ward dba I 30193 Highway 84 ) COMPANY LETTER D: Dolores, CO $1323 I COMPANY LETTER E: I COVERAGES THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMW ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT To wxlCx 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 I I I POL_ EFF. I POL. b". I LTRI TYPE OF INSURANCE I POLICY NU1QSR I DATE I D4TE I LIMITS IGENBRAL LIABILITY I ( I I GENERAL AGGREGATE $ 1,000,000 A I(XI COMMERCIAL GENERAL LIABILITY( UPKE023812 104/01/96 ) 04/01/97 1 PRODUCT-CAMP/OPS AGG_ $ 1,000.000 I ( ) CLAIMS MADE (X) OCCUR. I I I ( PERSONAL & ADV. INJURY S 1,000,000 It J OWNER'S & CONTRACTOR'S PROT.1 I I ( EACH OCCURRENCE S 1,000,000 [ J i I I I FIRE DAMAGE (Any one fire) S 50,000 { i i MED. EXPENSE (Any one person)S 5,000 (AUTOMOBILE LIABILITY I I I 1 It 3 ANY AUTO I I I I COMBINED SINGLE LIMIT 5 It I ALL OWNED AUTOS ( I I 1 ICJ SCH XTLM) AUTOS I 1 I I BODILY INJURY (Per person) S I [ 7 HIRED AUTOS I { I I ) [ J NON-OWNED AUTOS I I I BODILY INJURY (Per Accident) S l [ ) GARAGE LIABILITY ( I I I It ) I I I I PROPERTY DAMAGE S (EXCESS LIABILITY I I I I 11 J UMBRELLA FORM I I I I EACH OCCURENCE S IC J OTHER THAN UMBRELLA FORM I [ ) I AGGREGATE S WORKER'S COMPENSATION i I [ I I STATUTORY LIMITS AND I I I I EACH ACCIDENT s I I I DISEASE-POLICY LIMIT S -` EMPLOYER'S LIABILITY I I I I DISEASE-EACH EMPLOYEE S (OTHER I I l { I I I I I s I I I I I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHXCLES/SPECIAL ITEMS ADDITIONAL INSURED LISTED AS: DEPARTMENT OF MINERALS AND C,EOLOpy CERTIFICATE HOLDER CANCELLATION ISHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 13EFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY IWILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE ICERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL ISUCH NOTICE SHALL 7MDOSE NO OBLIGATION OR LIABILITY OF ZANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES_ DIVISION OF MINERALS AND GEOLOGY { [AUTHORIZED REPRESENTATIVE 1313 SHERMAN STREET ROOM 215 [ DENVER, CO 80203 [ I > . FORM 25-S (7/90)