2013-10-07_GENERAL DOCUMENTS - C1981047

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Client#: 123725 SBHOLDINI DATE (MM/DD/YYYY) ACORD,. CERTIFICATE OF LIABILITY INSURANCE 10/02/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed, if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Anita Keller HUB international ins Svcs Inc PHONE g70254 3306 A/C No Ext : 970-254-3306 A/C, No): 866-908 -6374 2742 Crossroads Blvd DRESS: anita .keller @hubinternationai.com Grand Junction, CO 81506 INSURER(S) AFFORDING COVERAGE NAIC A 888 245 -8011 INSURER A: Employers Mutual Casualty Compa INSURED S & B Holdings LLC Minrec Inc 627 241/2 Rd Unit H Grand Junction, CO 81505 COVFRAr,FS CERTIFICATE NUMRFR- INSURER 6: INSURER 0: 064 1 I 1 INSURER E: INSURER F: CA License #0757776 REVISION ...n THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE 111MME POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR LTR TYPE OF INSURANCE ADDL IN SR UBR WVD POLICY NUMBER POLICY EFF MM /DD/YYYY POLICY EXP MM /DD/YY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR X 3X6490414 /01/2013 09/01/2014 EACH OCCURRENCE $1,000,000 PREMISES Ea oxuErrOence $100,000 MED EXP (An one person s5,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC JECT PRODUCTS - COMP/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY t DAMAGE Per acciden $ $ UMBRELLA LIAB EXCESS LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ DEC) I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR/PARTNER/EXECUTIVE - N OFFICERMIEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WC STATU- OTH- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS f VEHICLES (A ACORD 101, Additional Remarks Schedule, N mom ace Is required) Re: Blue Ribbon Mine - File No C- 81- 047/State re of Colorado, Division of Minerals & Geology is included as Additional Insureds. State of Colorado SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Division of Minerals & Geology ACCORDANCE WITH THE POLICY PROVISIONS. 1313 Sherman St, Room 215 Denver, CO 80203 AUTHORIZED REPRESENTATIVE / ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of I The ACORD name and logo are registered marks of ACORD *_Q9Ard7971 U9A4'%A7A INA9