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P o licp N o !!. P P 3358 DECLARATIONS Item 1. N A M E D IN S U R E D M t B R - a X M K B R X M J C M J G R P , , L T D . , A C O R F C R A T I O T Add™, 3 0 2 0 SMPEt* ATCHOS, BOBBMB, C A U fttllA (N o . street, town, county, state) Item 2. Policy Period: From 1 2 S H , J $ 5 ® a tU » 0 U * M - to Q C ^ S B R U K . X * 5 X at 12:01 A 'M ” ?f standard tim e at the place where any operations covered hereby are conducted. Item 3. The Company’s liability under each coverage specified in Paragraph I, "Insuring Agreements,” shall be lim ited to the fo llo w in g sums respectively as to each such coverage and applicable as set forth in paragraphs 3 and 4 o f the Conditions hereinafter stated. C O V E R A G E A B odily Injury Liab ility- 3 2 ? » 0 0 Q . 0 0 -Each Person- Each -Occurrence C O V E R A G E B Property Dam age L iab ility- C O V E R A G E C B odily Injury Liability_____ Each -A ccident- -Aggregate -Each Person_ 5 0 , 0 0 0 . 0 0 Each -Occurrence C O V E R A G E D Property Dam age Liab ility- Each -Accident- ^ 5, 000*00 -A ggregate Item 4. Description o f principal w ork covered by this policy and classification o f risk. » « r k t m i P a c i f i c N l m l m m a S /m l% * a f f i l i a t e d C a m p a n i a * a * f o i l o v a i c l e a n :m s o u r m t m w i l l s , l a s FBQA3. SmSA* BAXSB ASt OIL m GAS qr -B* CONmCTCRS Clerical Office Code N o . 3485 PREMIUM BASES (a) Estimated Remuneration R A T E S Coverage A Coverage B (a ) Per $100 o f Remuneration •m Coverage C . 37* Coverage D . 3 7 6 Minimum Premiums: Coverage A $ MM Coverage C $ H O W S Coverage B $ 3 1 * 6 0 Coverage D $ H O M S Total A d van ce Premium ! * 3.70 T h e Provisions, Agreements, Exclusions and Conditions printed or written by the Company on the First and Second pages (Face and Reverse sides) hereto are a part o f this Policy as fu lly as i f recited over the signatures hereto affixed. ' I N W IT N E S S W H E R E O F , the Pacific Employers Insurance Company has caused this policy to be signed by its President and Secretary, but the same shall not be binding-upon the Company until countersigned by a duly authorized representative o f the Company. Secretary President Countersigned M S C j M M M g A ..this.. M l . . ..day of.. .19.n. Authorized RepresenUitiu The P A C IF IC E M PLO Y EE S IN SU R A N C E C O M PANY (a stock insurance company hereinafter called the “ Company” ), does hereby agree with t^e^Sisured' named in the Declarations made a part hereof, in consideration of the payment of the premium and of the statements contained in said Declarations, and subject to the limits of liability, exclusions, conditions and other terms of this policy: ’ INSURING AGREEMENTS I - to pay on behalf of the Insured all sums which the Insured shall become obligated to pay by reason of Insured by law for damages, including damages for care and loss of services, because of bodily injury, sickness, or disease (including death at any time resulting’ therefrom) sustained or incurred by any person or persons during the policy period and arising by reason of or m connection with performance by the Insured, as a general contractor and/or as a subcontractor, of business operations or work (whether or not described in said Declarations) for the Union Pacific Railroad Company and/or its affiliated companies. Liabi W t0 behalf of the Insured all sums which the Insured shall become obligated to pay b y reason S i l s l Ins)i red by law for damages.because of injury to or destruction of property, including the loss of use thereof, caused by accident occurring during the policy period and arising by reason of or in connection with pertormknce by the Insured, a k a general contractor and /or as a subcontractor, of business operations or work (whether or not described in said Declarations) for the Union Pacific Rail- liRoad Company and /or its affiliated companies. I I 8-50