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L <br /> v` <br /> CERTIFICATE OF INSURANCE <br /> ISSUE DATE 04/25/96 <br /> PRODUCER I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS <br /> Frost McGahey Insurance, Inc. NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, <br /> P.O. Box 8410 I EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> 235 South Ridge Street <br /> Breckenridge, CO 80424 COMPANIES AFFORDING COVERAGE <br /> i <br /> COMPANY LETTER A: UNION INSURANCE COMPANY <br /> RFrFl1/FD <br /> COMPANY LETTER B: MAY O INSURED I COMPANY LETTER C: 19Q`96 <br /> Ray Ward Trucking, Ray Ward and Guyrene Ward dba <br /> 30193 Highway 84 i COMPANY LETTER D: DIVISIdfi of N1It]efaIS&GeniQgy <br /> Dolores, CO 81323 <br /> COMPANY LETTER E: <br /> I <br /> COVERAGES <br /> THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> CO I POL. EFF. POL. EXP. I <br /> LTRI TYPE OF INSURANCE I POLICY NUMBER I DATE DATE I LIMITS <br /> IGENERAL LIABILITY I I I I GENERAL AGGREGATE $ 1,000,000 <br /> A I [X] COMMERCIAL GENERAL LIABILITY( UPK5023812 104/01/96 104/01/97 I PRODUCT-COMP/OPS AGG. $ 1,000,000 <br /> I [ ] CLAIMS MADE (XJ OCCUR. I I I I PERSONAL & ADV. INJURY $ 1,000,000 <br /> I [ ] OWNER'S & CONTRACTOR'S PROT.I I I I EACH OCCURRENCE $ 1,000,000 <br /> I ( J I I I I FIRE DAMAGE (Any one fire) $ 50,000 <br /> MED. EXPENSE (Any one person)$ 5,000 <br /> (AUTOMOBILE LIABILITY I <br /> I [ ] ANY AUTO I I I I COMBINED SINGLE LIMIT $ <br /> I [ ] ALL OWNED AUTOS I I I I <br /> I ( ] SCHEDULED AUTOS I I I I BODILY INJURY (Per person) $ <br /> I [ ] HIRED AUTOS <br /> I [ J NON-OWNED AUTOS I I I I BODILY INJURY (Per Accident) $ <br /> I [ ] GARAGE LIABILITY <br /> I [ ] I I I I PROPERTY DAMAGE $ <br /> (EXCESS LIABILITY <br /> I [ J UMBRELLA FORM I I I I EACH OCCURENCE $ <br /> I ( ] OTHER THAN UMBRELLA FORM I I I I AGGREGATE $ <br /> WORKER'S COMPENSATION I I I I I STATUTORY LIMITS <br /> I I I I <br /> AND I I I I EACH ACCIDENT $ <br /> DISEASE-POLICY LIMIT $ <br /> EMPLOYER'S LIABILITY I I I I DISEASE-EACH EMPLOYEE $ <br /> (OTHER <br /> I I I I I $ <br /> I I I I I $ <br /> I I I I I <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS <br /> ADDITIONAL INSURED LISTED AS: DEPARTMENT OF MINERALS AND GEOLOGY <br /> CERTIFICATE HOLDER CANCELLATION <br /> ISHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br /> (BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY <br /> IWILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE <br /> ICERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL <br /> (SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF <br /> ZANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. <br /> DIVISION OF MINERALS AND GEOLOGY <br /> (AUTHORIZED REPRESENTATIVE <br /> 1313 SHERMAN STREET ROOM 215 I <br /> DENVER, CO 80203 i <br /> I <br /> FORM 25-S (7/90) <br />