2014-08-05_GENERAL DOCUMENTS - C1981019

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A� " CERTIFICATE OF LIABILITY INSURANCE 7OT7/29/2014 E/Y 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 1- 612- 333 -3323 Hays Companies .. 80 South 8th Street Suite 700 CONTACT Lace Skalick NAME: Y Y PHONE FAX IA No Ext: 515- 802 -3005 AIC No 515 - 802 -3032 E -MAIL ADDRESS: lakalickyWhayscompanies.com GENERAL LIABILITY Minneapolis, MN 55402 INSURERS AFFORDING COVERAGE NAIC# INSURERA: LEXINGTON INS CO 19437 OM .04 INSURED ROY; COLOWYO COAL COMPANY L.P. O NATIONAL UNION FIRE INS CO OF PITTS INSURER B 19445 INSURER C INSURER D: `\ ,,1 1100 West 116th Avenue "A ! -'\� Westminster, CO 80234 - INSURER E CLAIMS -MADE lxl OCCUR 1'A INSURER F: COVERAGES CE0 E NUMBER: 40866820 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. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY LIMITS A GENERAL LIABILITY 021396066 08/01/1 08/01/15 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE PREMISES S ( Ea occurre RENTED ce n $ 100,000 CLAIMS -MADE lxl OCCUR MED EXP (Any one person) $ PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2.000,000 $ POLICY PRO X LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS B X UMBRELLA LIAB X OCCUR BE12816213 08/01/1 08/01/15 EACH OCCURRENCE $ 25,000,000 AGGREGATE $ 25, 000, 000 EXCESS LIAB CLAIMS -MADE DED I X I RETENTION$ 10, 000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN WC STATU- OTH- TORY LIMIT R ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ NIA (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Evidence of Insurance as respects Colowyo Coal Company, L.P. (Permit #C -81 -019). Includes use of Explosives GtK I It-ILA It HULUtK Colorado Mined Land Reclamation Mined Land Division 1313 Sherman Street, RM 215 Denver, CO 80203 ACORD 25 (2010/05) TOlmstead 40866820 USA 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 © 1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD