2014-07-02_GENERAL DOCUMENTS - C1981022

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A�ORO CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD /YYYY) 06/04/2014 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 Aon Risk services, Inc of Florida 222 Lakeview Avenue CONTACT NAME: (A/C.. NN . Ext): C866) 283 -7122 FAX No.): (800) 363 -0105 E -MAIL suite 510 West Palm Beach FL 33401 USA ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # $1,000,000 INSURED INSURER A: Zurich American Ins Co 16535 Oxbow Mi ni nq , LLC INSURER B: $10,000 1601 Forum Place INSURER C: PERSONAL &ADV INJURY suite 1400 West Palm Beach FL 33401 -8101 USA INSURER D: $5,000,000 INSURER E: $2,000,000 INSURER F: A AUTOMOBILE LIABILITY AI NY AUTO X ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS COVERAGES CERTIFICATE NUMBER: 570054013779 REVISION NUMBER: 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. Limits shown are as requested INSR LTR TYPE OF INSURANCE AUIJ INSD WVD POLICY NUMBER MM /DD /YYYY MM /DD /YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD GLO General Liablity SIR applies per policy terns & condi ions EACH OCCURRENCE $1,000,000 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. PRO-F_X] POLICY ❑ JECT LOC OTHER: GENERAL AGGREGATE $5,000,000 PRODUCTS - COMP /OP AGG $2,000,000 A AUTOMOBILE LIABILITY AI NY AUTO X ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS BAP 9265950 -04 Business Automobile cover 06/01/2014 06/01/2015 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY ( Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE Per accident UMBRELLA LAB EXCESS LAB OCCUR CLAIMS -MADE EACH OCCURRENCE AGGREGATE DED RETENTION 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 PER OTH- STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE -EA EMPLOYEE E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Elk Creek Mine Permit #1981 - 022 CERTIFICATE HOLDER CANCELLATION C Division of Reclamation 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 Mining and safety - 1313 Sherman Street Room 215 n�4o/ /92%]l)�dD1Gp Denver Denver CO 80203 USA e st.�irxQ �za c/��y ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD