2014-10-06_GENERAL DOCUMENTS - C1981014 (2)

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ENERG -1 OP ID: PO 14coR0' CERTIFICATE OF LIABILITY INSURANCE �� DATE 10 /01 /2014 ) 10/01 /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 Steamboat Select Insurance 675 Snapdragon Way, Suite 200 CONTACT NAME Todd A. Hayes, MBA, CIC n/ °NN ,l: 970-879-1363 ac NO I: 970 - 879 -0239 Steamboat Springs, CO 80487 Todd A. Hayes, MBA, CIC E -MAIL ADDRESS: COMMERCIAL GENERAL LIABILITY INSURER (S) AFFORDING COVERAGE NAIC # INSURER A: Great Midwest Insurance CO 18694 $ 1,000,000 INSURED Energy Fuels Corporation Lindsay Yates PO Box 773457 INSURER B: INSURER C GL0001108004 INSURER D: I 10/01/2015 Steamboat Springs, CO 80477 -3457 INSURER E: $ 100,000 INSURER F: $ 5,000 COVERAGES CERTIFICATE NUMBER: 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 SU R POLICY NUMBER POLICY EFF MM /DD/YYYY POLICY EXP MM /DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE Al OCCUR GL0001108004 10/01/20141 I 10/01/2015 DAMA E RENTED rence PREMISES Ea occur $ 100,000 MED EXP (Any one person) $ 5,000 X Employee Benefits PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO- ❑ ❑ JECT LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS O PROP RTY DAMAGE $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE O, AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR /PARTNER/EXECUTIVE OFFICER /MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under N/A �\ r FZe ^ �1y �T r' 7 PER STATUTE �R H E.L. EACH ACCIDENT $ E.L. DISEASE - EA EPAPLOYEE 3 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ I I DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Southfield Mine - Permit #C -81 -014. LatK I It-ILA I t MULUtK GANGtLLA I IUN CNATURA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Colorado Division of Reclamati ACCORDANCE WITH THE POLICY PROVISIONS. Mining and Safety Division of Minerals & Geology AUTHORIZED REPRESENTATIVE 1313 Sherman Street, Rm 215 iDenver, CO 80203 © 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD