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AKRENE-01 MADO <br />4 CORD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) <br />*M 12/4/2003 <br />PRODUCER (940) 723-0771 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />son Mason Daugherty Ins <br />~® <br />I <br />h R <br />D <br />,~ <br />p <br />~ HOLDER. <br />TH S CERTIFICATE DOES NOT AMEND <br />EXTEND OR <br />O B x <br />107 <br />P <br />~~~ ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Wichita Falls, TX 76307.1071 <br />Qp3 <br />Q ~ Z INSURERS AFFORDING COVERAGE NAIC # <br />INSURED Oakridge Energy Inc; Pueblo Mining <br />G W9GRERA:Hid-Continent Casualty Co. ' <br />I8~58Pa <br />~ <br />y Okl <br />S <br />h <br />C <br />`MC <br />DtM <br />~ a <br />urety <br />ompany _ <br />oma <br />wsuREHe: _ _ .- <br />\UP <br />. • W ch la F IIs <br />TX 76302 <br />-., ,--, 01N`e INSURERCTexasMutuallnsuranceCo. <br />_ ~ ~ ' ~ INSURER D: - <br /> INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAV PERTAIN, THE INSURANCE AFFORDED BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAV HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR ADD• <br />LTR RD POLICY NUMBER POLICY EFFECTIVE <br />M/ POLICY EXPIRATION <br />MIDO LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 <br />A X COMMERGIALGENERALLIARILITV 04GL000529682 12/512003 12/$/2004 PREMISES Eaoccurence $ 100,00 <br /> - CLA!MSMADE OCCUR MEDEXP(Anyoneperson) $ EXCLUDED <br /> PERSONAL BADV INJURY $ 1,000+00 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-GOMPIOP AGG $ 2,000.00 <br /> X POLICY PRO- LOC <br /> AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,40 <br />B ANY AUTO O6TX002901987 12/5/2003 12/5/2004 (Ea acudenp <br /> ALL OW NEO AUTOS BODILY INJURY - <br />$ <br /> X SCHEDULED AU70S (Per person) _ <br /> X HIRED AUTOS ~•~'~''~~ <br />- <br />~ <br />BODILY INJURY <br />$ <br /> X NON-OWNED AUTOS ~ ~ ~ IPer accitlenp <br /> - - - PROPERTY DAMAGE - ' <br /> _ _ _ <br />' - _ P $ <br /> er accident) <br />( <br /> ' GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ <br /> ANYAUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG 8 <br /> E%CE$$IUMBRELLA LIABILITY EACH OCCURRENCE $ 1,000,000 <br />A X OCCUR ~cLA1MSMADE XS128114 12/5/2003 12/5/2004 AGGREGATE s 1.000,000 <br /> <br /> DEDUCTIBLE 3 <br /> X RETENTION $ 10,000 $ <br /> WORKERS COMPENSATION AND X TORY LIM T$ OER _____ <br />C EMPLOYER$'LIABILITY^ _., __ <br />ANV PROPRIETORIPARTNER/EXECUTIVE SBP1027321 - - - -'7/14/2003 7/14/L004 EL EACH ACCIDENT _ <br />$ 1+000,00 <br /> OFFlCER/MEMBER EXCLUDED E.L. DISEASE - EA EMPLOYEE S 1,000, W <br /> It es. describe under <br />SPECIAL PROVISIONS below <br />E.L, DISEASE -POLICY LIMIT 1,000,000 <br />g <br /> OTHER <br />DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />Carbon Junction Coal Mine, Durango Colorado Permit #C-92.080 <br />CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />Colorado Division Of Minerals & Geology PATE THEREOF, THE ISSUING INSURER WILLXd61flISA6XY3MAll 3O DAYS WRITTEN <br />1313 Sherman Room 215 <br /> <br />Attn Harry Ranney NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, e>~1tX,1~Xxx,XasxXaaxL <br />Denver, CO 80203- X+1t~xX~t7~X-0(dLIMI(XIXAG14xXPriXiIOGXdrJSXdCdbKA4ItC~WOxd6XlfdCXX <br /> xs~xlxacasx;'N€tc <br /> AUTHORIZED REPRESENTATIVE <br />ACORD 25 (2001/08) ©ACORD CORPORATION 1988 <br />