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ACORD CERTIFICATE OF LIABILITY INSURANCF,~ OP ID DATE (MM/DWVY) <br />CIGF-1 06/29/05 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Slaachard Iasurance Group Iac . HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />P.O. Box 60130 ALTER THE COVERAGE AFFORDED BV THE POLICIES BELOW. <br />Grand Jnnct iOn CO 81506 INSURERS AFFORDING COVERAGE <br />Phone: 970-245-8011 Fax:970-245-6016 <br />INSURED INSURER A Employers Mutn81 C88n81ty CO. <br />INSURER B: <br />C.B. Minerals Co>n8an77[[L LLC INSURER C: <br />6717 Dal4any Avenue 8T115 INSUREfl D: <br />Playa del Rey CA 90293 <br />INSURER E: <br />COVERAGES <br />7HE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANV REQUIREMENT, TERM OR CONDITION OF ANV CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAV 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 BV PAID CLAIMS. <br />LTR TYPE OF INSURANCE POLICY NUMBER DATE MIDD/YY GATE MM/DDM' LIMBS <br /> GENERAL LIABILITY EACH OCCURRENCE 8 SOD, OOO <br />A X COMMERCIAL GENERALLIABILITV 1X15286 07/12/05 07/12/06 FIREDAMAGE(Anyona/ire) $ 100,000 <br /> CLAIMS MADE OCCUR MED EXP (AAy one parson) $ S, OOO <br /> PERSONAL EADV INJURY $ SOD, OOO <br /> GENERAL AGGREGATE $ 1, OOO, OOO <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S S, OOO, OOO <br /> POLICY PRO LOC <br />JECT <br /> AUT OMOBILE LIABILRY <br /> <br />ANV AUTO <br />COMBINED SINGLE LIMIT <br />(Ea aaitlent) <br />§ <br /> ALL OWNED AUTOS <br /> <br />SCHEDULED AUTOS <br />BODILY INJURY <br />(Per person) <br />§ <br /> HIRED AUTOS <br /> <br />NON-OWNED AUTOS <br />BODILY INJURY <br />(Per eccitlent) <br />§ <br /> PROPERTY DAMAGE <br /> <br />(Per amitlent) $ <br /> GARAGE UABIUTV AUTQ ONLY-EA ACCIDENT $ <br /> ANV AUTO OTHER THAN ~ ACC $ <br /> AUTO ONLY: AGG E <br /> EXCESS LIABILITY EACH OCCURRENCE $ <br /> OCCUR ~ CLAIMS MADE AGGREGATE $ <br /> E <br /> DEDUCTIBLE $ <br /> flETENTION $ § <br /> WORKERS COMPENSATION AND TORY LIMITS ER <br /> EMPLOYERS' LIABILITY <br />_ ~ __. <br />____ ____.~ _ <br />~..~ <br />_ __._ <br />E.L. EACH AGGDENT-- <br />.§----- . <br /> E.L. DISEASE-EA EMPLOYE $ <br /> E.L DISEASE-POLICY LIMIT $ <br /> OTHER <br />CEIVED <br />DESC RIPTION OF OPERATX]NSlLOCATIONSNE HICLESlEXCLUSK]NS ADDED BY ENDORSEME NT/SPEGAL PROVISIO NS <br />DMG Permit No. C-84-065 - Coal Ridge No. 1 Miae East of New Castle, CO ~~~ 05Zp05 <br />South of the River. NCIG Financial, Iac. an8 the State of Colorado Division <br />of Minerals & Geolo4y are included as Additional Iasureds. *10 Days Notice <br />For Non-Payment Of Premium **or iacur substaat ive changes or failure to ~ ~~M)Derals aRAGeoFWY <br />CERTIFICATE HOLDER N ADDRIONAL INSURED; INSURER LETTER: _ CANCELLATION ** <br />DD DDDDD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED EFORE THE EXPIRATION <br />State Of ColOradO DATE THEREOF, THEISSUING INSURER WILL )D1~8~®MAIL ~}Q DAYS WRITTEN <br />D1Vi8i0II Of Miner8le & Geology NOTICE TO THE DERTIFlQpTE HOLDER NAMED TO THE LEFT.1D777F7i1NIpS]Q}7ImSaE871rfL <br />1313 Sharman Street, Room 215 IGBbY~,OlsBdtaRSUBI[ocX~lOX~m»xxaf7Earos~Wtx <br />Denver CO 80203 <br />xa$Naca~anst¢e¢r;lc i1 <br />25-5 (7/97) -/- ®ACORD CORPORATION 1986 <br />