2014-02-11_GENERAL DOCUMENTS - C1980001

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�'� °® CERTIFICATE OF LIABILITY INSURANCE DATE /2014 /YYYY) 02/04/2014 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. 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 CONTACT NAME: MARSH RISK & INSURANCE SERVICES PHONE FAX 345 CALIFORNIA STREET, SUITE 1300 A/C No Ext : A/C No): E -MAIL ADDRESS: CALIFORNIA LICENSE NO 0437153 SAN FRANCISCO, CA 94104 $ 1,000,000 X COMMERCIAL GENERAL LIABILITY INSURERS AFFORDING COVERAGE NAIC # INSURER A : ACE American Insurance Company 22667 025158- 0001 - GAWXL -14 -15 SPEC 007C INSURED CHEVRON MINING, INC INSURER B: X CLAIMS -MADE OCCUR 116 INVERNESS DRIVE INSURER C : INSURER D: MED EXP (Any one person) SUITE 207 ENGLEWOOD, CO 80112 $ 1,000,000 INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: SEA- 002032363 -49 REVISION NUMBER: 19 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR 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 SUBR D POLICY NUMBER POLICY EFF MM /DD /YYYY POLICY EXP MM /DD/YYYY LIMITS A GENERAL LIABILITY CMR G25840458 03/01/2014 03/01/2015 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea Occurrence) $ X CLAIMS -MADE OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 1,000,000 $ POLICY PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea .cadent $ BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS A UMBRELLA LIAB OCCUR XLX 625840483 03/01/2014 03/01/2015 EACH OCCURRENCE $ 3,500,000 X AGGREGATE $ 6,500,000 X EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR /PARTNER/EXECUTIVE WC STATU OTH- RY IM IT - R E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) EL DISEASE - EA EMPLOYE $ EL DISEASE -POLICY LIMIT 1 $ If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) This Certificate shall provide for personal injury and property damage as a result of surface coal mining and reclamation operations including arising from the use of explosives at the Insured "s Edna Mine in Colorado The issuing Company shall notify the below named Certificate Holder whenever substantive changes are made in the above described policies Including termination or failure to renew, within 30 days SGc�t� j/v, Cr rrI Ct �Jcc 11,4 AV 11W yiP- �F�v�,1 /, y CERTIFICATE HOLDER CANCELLATION Division of Reclamation, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Minerals and Safety THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn Janet Blnns ACCORDANCE WITH THE POLICY PROVISIONS. 1313 Sherman Street, Room 215 Denver, CO 80203 -2273 AUTHORIZED REPRESENTATIVE of Marsh Risk & Insurance Services Wendy Sokol hey a © 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD