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a®:®®e:ir. CERTIFICATE OF INSURANCE 01 ~ ~ 10 010 ~ ~~ ~~~~ 0~0 ISSUE DATE IMM/OD/YY) <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND <br />FLAT TOP I.V$UR4iJCE AGENCY CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE <br />DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE <br />32D F~7~RAL STF;E~T POLICIES BELOW. <br />?. '~. 3UX 1439 COMPANIES AFFORDING COVEAAGE <br />'LUEFI`_l~ <br />riV ZL i O1 OOOO COMPANY <br />A <br />304-327-3421 LETTER <br />UND"cR.WRITGRS AT LLJYDeS AtiL~ <br /> COMPANY <br />B <br />INSURED LETTER <br />VARIOUS II~lSU2AMCE CG~IPA`iIES <br />$Uld G7AL CO"!P ANY I`JC. COMPANY <br />C <br />IO.ZOJ 4J. 44TH - SUITc 12u LETTER <br />:~IiCAT RTL GE COMPANY <br />D <br />l.G 30'J330000 LETTER <br /> COMPANY E <br /> LETTER <br />COVERAGES <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED 70 THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED, NOTWITHSTANDING ANV REOUIREMENT,~TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAV PERTAIN, THE INSURANCE AFFORDED BY THE POLICIEu DESCRIBED HEREIN IS SUBJECT TO ALL THE TERiAS, <br />E%CLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BV PAID CLAIMS. <br />CO TYPE OF INSURANCE POLICY NUMBER <br />LTR POLICY EFFECTIVE POLICY E%PIRATION LIMIT9 <br />DATE (MM/DD/YY) DATE (MMIODIVY) <br />A GENERAL LIABILITY 920033 lI/pl/92 11/C1/93 GENERAL AGGREGATE S Z~O(J O~(~lJ t_ <br />~' COMMERCIAL GENERAL LIABILITY PRODUCTS-COMPIOP AGG. f 2 T OO O I O O I. <br />CLAIMS MADE )( OCCUR. PERSONAL BADV. INJURY S 2r.Jn0r 00~ <br />OWNER'S 6 CONTRACTOR'S PROT. ~ EACH OCCURRENCE S 2 ~ O.OO.O O <br /> FIRE DAMAGE (Any one lire) f 2 r O OO. O O L <br /> MED. E%PENSE (My one person) f <br />AUTOMOBILE LIABILITY COMBINED SINGLE <br />f <br />ANY AUTO LIMIT <br />ALL OWNED AUTOS <br />BODILY INJURY S <br />~ <br />SCHEDULED AUTOS ~ fPer penonj <br />` e ~ ~ <br />' <br />\ <br />NIRED AUTOS ~~ ~' <br />V <br />BODILY INJURY f <br />NON-OWNED AUTOS IPer eccitlenl) <br />GARAGE LIABILITY ~gg~ <br /> PROPERTY DAMAGE S <br />lVO Y 4 <br />E%CESS LIABILITY \ I `` IT EACH OCCURRENCE f <br />J <br />` <br />UMBRELLA FORM ~ AGGREGATE f <br />~~IJ{- l~ <br />D`V+J <br />S <br />OTHER THAN UMBRELLA FORM <br />1 <br />d <br />~RA` <br />1 <br />; <br />WORKER'S COMPENSATION STATUTORY LIMITS <br /> EACH ACCIDENT f <br />ANO <br /> DISEASE-POLICY LIMIT f <br />EMPLOYERS' LIABILITY - <br />DISEASE-EACH EMPLOYEE S <br />OTHER <br />A POLLUT?^r; 520033 11/G1/?2 11/C 1/43 2rOJ0.000 <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEM9 <br />M~ADUW$ MIiiE PERMIT ;~C-91-029 <br /> /RG'~ <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />CCLGRA00 MINE? LA\D 4cCLA`i4TICN CIV EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILLo <br />A'I T~J a Y; S ~ U'J AN MGRJi I $v N MAIL' D I O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE <br />RGG~ 215. S_NTE.VP/IAL ~LOv. LEFT, <br />1313 $HERMA'J ST2EFT <br />ntNVErt Gn ~O2'~3 AUTHORIZED REPRESENTATIVE <br />FLAT TOP INSURANCE AGENCY <br />ACORD <br /> <br />®ACORD CORPORATION 7990 <br />