2014-06-09_GENERAL DOCUMENTS - C2010088 (2)

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ZT ACORb° CERTIFICATE OF LIABILITY INSURANCE �Nlll 6/1/2015 DATE(MM /DD/YYYY) 5/28/2014 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 Lockton Companies Three City Place Drive, Suite 900 St. Louis MO 63141-7081 (314) 432 -0500 NAME: PHONE AIC, No Ext : A/C No): E-MAIL ADDRESS: N GL1903168 6/1/2014 INSURERS AFFORDING COVERAGE NAIC # INSURER A: National Union Fire Ins Co Pittsburgh PA 19445 DAMAGE TO RENTED PREMISES Ea occurrence INSURED CAM Colorado, LLC INSURER B: Lexington Insurance Company 19437 1340392 PO Box1169 Pikeville KY 41502 Division of Reclamation, Mining &Safety INSURER C: INSURER D $ 1,000,000 INSURER E GENERAL AGGREGATE INSURER F: PRODUCTS - COMP /OP AGG $ 2 000 000 COVERAGES RHIRE CERTIFICATE NUMBER: 12139435 REVISION NUMBER: XXXXXXX 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 INSD SUBR WVD POLICY NUMBER POLICY EFF MM /DD/YYYY POLICY EXP MM /DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR Y N GL1903168 6/1/2014 6/1/2015 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence 1 000 000 MED EXP (Any one person) 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER POLICYa JE O LOC OTHER GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2 000 000 $ A AUTOMOBILE LIABILITY X ANY AUTO ALL UTOWNED SCHEDULED NON -OWNED HIRED AUTOS AUTOS N N CA5775970 6/1/2014 6/1/2015 (CEO, a,:CderlSINGLE LIMIT $ 1,000, 000 BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident $ XXXXXXX PROPERTY DAMAGE Per accident $XXXXXXX $XXXXXXX B X UMBRELLA LIAB EXCESS LIAB OCCUR N lit 013136615 6/1/2014 6/1/2015 EACH OCCURRENCE $ 5,000,000 HCLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION $ Prod.- Comp /Op $ 5,000,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A NOT APPLICABLE PER OTH- STATUTE E.L. EACH ACCIDENT `� V V V $ XXXXXXX E.L. DISEASE - EA EMPLOYEE XXXXX XX E.L. DISEASE - POLICY LIMIT v V V XXXXXXX DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: UNIT TRAIN LOADOUT DRMS PERMIT # C- 2010 -088. STATE OF COLORADO RECLAMATION AND SAFETY IS ADDITIONAL INSURED UNDER GENERAL LIABILITY WHERE REQUIRED BY WRITTEN CONTRACT. 12139435 STATE OF COLORADO DIVISION OF RECLAMATION MINING AND SAFETY 1313 SHERMAN ST. RM #215 DENVER CO 80203 r.�.�.� e7.ylif lrl; inrtTi �� SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE t7 1 The ACORD name and logo are registered marks of ACORD s All riahts reserved