2014-06-09_GENERAL DOCUMENTS - C1981020

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0- :4 61 X31 --ozo Zr ACORb' CERTIFICATE OF LIABILITY INSURANCE 6/1/2015 DATE(MM /DD/YYYY) 1 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 `�`jO C V GUNIAUI NAME: E FA A/c, Ext : A/C No E -MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A : National Union Fire Ins Co Pittsburgh PA 19445 04 INSURED Rhino Resource Partners LP 1340392 PO Bo lI 1i; g�LLC g �p�4 6 , \`N` Pikeville KY 41502 ,v, ` O ��(�� , tI 0{ Fz Q. INSURER B: Lexington Insurance Company 19437 INSURER C: 6/1/2015 INSURER D: 1,000,000 INSURER E: DAMAGE TO RENTED PREMISES Ea occurrence INSURER F: COVERAGES RHIRE CEW'I' NCAA'fi1UMBER: 11291473 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 SUER WVD POLICY NUMBER POLICY EFF MM /DD/YYYY POLICY EXP MM /DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR N 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 PL ' AGGREGATE LIMIT APPLIES PER: POLICY JE FX LOC OTHER GENERAL AGGREGATE $ 2,,000,000 PRODUCTS - COMP /OP AGG $ 2 000 000 $ A AUTOMOBILE LIABILITY X ANY AUTO A L AUTOS NED SCHEDULED NON -OWNED HIRED AUTOS AUTOS N N CA5775970 6/1/2014 6/1/2015 Ea accidentSINGLE LIMIT $ 1 OOO 000 BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident $ XXXXXXX PROPERTY DAMAGE Per accident $XXXXXXX $XXXXXXX B X UMBRELLA LIAB EXCESS LIAR OCCUR N N 013136615 6/1/2014 6/1/2015 EACH OCCURRENCE $ 5,000,000 HCLAIMS-MADE AGGREGATE $ 5,000,000 DED I I RETENTION $ Prod.- Comp /Op $ 51000,000 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 I PER OTH- STATUTE E.L. EACH ACCIDENT `T $ XXXXXXX E.L. DISEASE - EA EMPLOYEE v XXXXXXX E.L. DISEASE - POLICY LIMIT XXXXXXX DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: MUNGER CANYON MINE, DRMS PERMIT 1981 -020 CERTIFICATE HOLDER CANCELLATION 11291473 DIVISION OF RECLAMATION MINING AND SAFETY 1313 SHERMAN STREET ROOM 215 DENVER CO 80203 ArORn 25 12014/n11 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 CC) 1 The ACORD name and logo are registered marks of ACORD N. All riahts reserved