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ACORD_ CERTIFIC. <br />INSURANCE <br />VNIC ImVaVWrlrr, <br />'°'°°°`^ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />:nItisk Services, Inc. <br />NOV ~ ( ~~ HOLDER.T HIS CFERTIFICATE DOES NOT AMENDREXTEND OR <br />i100 Western Place, Suite 100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />?ort Worth TX 76107 <br />Phone: 817-677-1884 O1N1sjp°Df MiBBT215 and 8e°p0~ INSURERS AFFORDING COVERAGE NAIC# <br />Abraxas Petroleum Corporation <br />Ms. Carol O'Brien <br />P.O. BOX '7OlOO7 <br />San Antonio TX 76270-1007 <br />INSURER A' st. Paul sviplun ones ma. <br />INSURER S: <br />INSURER C: <br />INSURER D: <br />INSURER E: <br />THE POLICES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITIiSTANDING <br />ANV RE-0UIREMENT, TERM OR CONDITION OF ANV CONTRACT OR OTHER DOCUMENT WffH RESPECT TO WHICH THIS CERRFICATE MAV BE ISSUED OR <br />MAV PERTAIN, THE INSURANCE AFFORDED BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDRIONS OF SUCH <br />POLICIES. AGGREGATE LIMBS SHOWN MAV HAVE BEEN REDUCED BV PAID CLAIMS. <br />TR NSR TYPE OF INSURANCE POLICY NUMBER GATE MMIDD DATE MMIDDM! N UMRS <br /> GENERAWABILffY EACH OCCURRENCE E 1,000,000 <br />A __ .X_ 1AMMEFCALC LIAeILRY. MU05533.725,.~_J-- _09/A1/.03- -__09/01/.04. PREMISeslEa~rea~) -s--100;000- <br /> CtAIMS MADE X^ OCCUR MED FXP (Any erne person) S 5 , D OO <br /> PERSONAL BADV INJURY S 1,000,000 <br /> GENERAL AGGREGATE S 2,000,000 <br /> GEN'L AGGREGATE LIMB APPLIES PER: PRODUCTS-COMP/OP AGG S 1,000,000 <br /> X POLICY JECT LOC <br /> AU TOMOBILE LV\BILITV COMBINED SINGLE LIMR <br /> ANY AUTO (EaaWCenH E <br /> Aft OWNED AU70$ <br />BODILY INJURY <br /> <br />SCHEWLED AUTOS <br />(Per person) S <br /> MIRED AUTOS <br />BODILY INJURY <br /> <br />NON-0WNED AUTOS <br />(Per aodoenU S <br /> PROPERTY DAMAGE <br /> <br />(Per acaQSlq E <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT E <br /> ANY AUTO OTHER THAN EA ACC S <br /> AUTO ONLY: AGG s <br /> EXCESSNMBRELLA LIABILTY EACH OCCURRENCE t <br /> OCCUR ~ CLAIMS MADE AGGREGATE S <br /> S <br /> DEDUCTIBLE S <br /> .RETEMK>BI_S _ _ <br /> WORKERS COMPENSATION AND TORY LIMBS ER <br /> EMPLOYERS UABILT' <br /> ANV PROPRIETOR/PARTNER(E%ECUTNE ~ E.L. EACH ACCIDENT E <br /> OFFICERAAEMBER EXCLUDED? EL. DISEASE-EA EMPLOYE S <br /> H yes oP.sa;beuMet <br /> SPECIAL PROVISIONS bebw E.L DISEASE-POLICY LIMR S <br /> OTHER <br />A:SC RIPNON OF OPERATIONS (LOCATIONS /VEHIC LES /EXCLUSIONS ADDED BV ENDORSE MENT / SPECULL PRO WSIONS <br />certificate Holder included as Additional Insured and Waiver of Subrogation <br />provided as required by written contract but only to the extent of such <br />contract and only for operations performed by or for the Named Insured. it <br />is warranted that no coal mining operations are being conducted by the <br />[nsured. "The Eastside Mine-CDMG Permit No C-1984-063 <br />;ERTIFICATE <br />MINEDLA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANOELLED BEFORE THE EXPIRATION <br />_ -OATETHEREOF, THE ISSUING INSURER WILL MAIL 3O DAYS WRITTEN <br />Mined Land ReClamatlOn NOTICE TO THE CERTIFlCATE HOLDER NAMED TO THE LEFT. <br />Atten: Byron Walker <br />1313 Sherman Street, Room 215 <br />Denver, CO 80203 AUTHORIZED REPRESENTA <br />1CORD 25 (2001/08) V ~ " ~---~~ ~ ©ACORD CORPORATION 1988 <br />