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ACORD CERTIFICATE OF LIABILITY INSURANCI ~~~ ~~~~~~~~~~~~~ ~~~ 5 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A mw I I cn ur Inr~nmH I IAN <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Blanchard Insurance Group Iac. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />P.O. Hox 60130 ALTER THE COVERAGE AFFORDED BY 7HE POLICIES BELOW. <br />Graced Junctioa CO 81506 <br />Phone: 970-245-8011 Fax: 970-245-8016 INSURERS AFFORDING COVERAGE <br />INSURED INSURERA ElltplOyera MutIIal C89u81ty CO. <br />INSURER B: <br />SF.M COIISstZM11Ct1QpII L'O. INSURER C: <br />715 ROri ZOII DriVe~ Salta 219 INSURER D: <br />Grand Junction CO 81506 <br />INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW NAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATE¢lfl{,'LiSyJ~Tj)~i~ 8 GCO~~Y <br />ANY REQUIREMENT, TERM OR CONDRION OF ANV CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WMICM THIS CERTIFICATE MA <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 MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />LTp TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MMID LIMRS <br /> GENERAL LU1BILffY EACH OCCURRENCE E1~000~OOO <br />A X COMMERCIAL GENERAL LIABILITY 9X90868 OS/10/Ol 05/10/02 FIRE DAMAGE(Any ane lire) S 100,000 <br /> CLAIMS MADE a OCCUR MED EXP (My one person) E 5 ~ OOO <br /> PERSONAL 8 ADV INJURY E 1 ~ OOO ~ OOO <br /> GENERAL AGGREGATE S 2 ~ OOO ~ OOO <br /> GEN'L AGGREGATE LIMB APPLIES PER: PRODUCTS-COMPAJP AGG E2~000~OOO <br /> POLICY JECaT LOC <br /> AU TOMOBILE LIABILffY <br />COMBINED SINGLE LIMB <br />S 1, OOO ~ OOO <br />A X ANr nuTO 9X90868 OS/10/O1 05/10/02 (Ee ecclaenl) <br /> ALL OWNED AUTOS BODILY INJURY <br />S <br /> SCHEDULED AUTOS (Per Perso^) <br /> X HIRED AUTOS BODILY INJURY <br />E <br /> X NON-OWNED AUTOS IPeramtlent) <br /> PROPERTY DAMAGE E <br /> (Per eccltleM) <br /> GARAGE LUU31LffY AUTO ONLY-EA ACCIDEM S <br /> ANV AUTO OTHER THAN EA ACC S <br /> AUTO ONLY: AGG E <br /> EXCESS LIABILITY EACH OCCURRENCE S <br /> OCCUR ~ CLAIMS MADE AGGREGATE S <br /> S <br /> DEDUCTIBLE E <br /> RETENTION S S <br /> WORKERS COMPENSATION AND _ _ TORY LIMITS ER <br /> EMPLOYERS' LIABILffY <br />E.L EACH ACCIDENT <br />E <br /> E.L. DISEASE ~ EA EMPLOYE S <br /> E.L. DISEASE ~ POLICY LIMIT S <br /> OTHER <br />DESCRIPTION OF OPERATION520CATIONS/VEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/BPECIAL PROVISIONS <br />RE: Hlue Ribboa Miae-File No C-81-047. State Of Colorado, Divisioa Of <br />Miaerals & Geology is included as as Additioaal Iasured.+10 Days Notice Duce <br />to Non-Payment Of Premium.++Or incur subataative chaages or failure to <br />renew. This certificate caacels and supercedes all prior certificates. <br />l.Cf\IIPII.XIC IIVLUCN T ADDIIIUNAL INJUX[UI INSUN[N L[1 I[H: p l.N1Yl.CLW IIVIY <br />OOOOOOO SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED EFORE THE E%FlRATION <br />State Of COlOiadO DATE THEREOF, THE ISSUING INSURER WILL~YIIY(I~~FITGAIL •30 DAYS WRITTEN <br />D1V1H7.aII Df M1IIer81a & GBOlogy NOTICE TO THE CERTIFlCATE HOLDER NAMED TO THE LEFT, ~I~CfX1YA1~fX~~IYLK <br />1313 Sherman Street Room 215 ~a~5~t#~r~161~D~GXIYelCIi6d6X~1G~X~Yr+lSACTYd4rXc~It~G3kXd~3iT1{dkY <br />Deaver CO 80203 .................. <br />7jhx .c <br />CORPORATION 1999 <br />