2014-11-04_GENERAL DOCUMENTS - C1981028

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A CORD, CERTIFICATE OF LIABILITY INSURANCE 11/1/2015 DATE (MM /DD/YYYY) 10/30/2014 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 8110 E Union Avenue ° J Suite 700 3 Denver CO 80237 (303) 414 -6000 P. POLICY NUMBER PNAZM5hj FA AIC R 11 No Ext : A/C No ADDRE IN R R AFFORDING COVERAGE NAIC # INSURER A: ACE American Insurance Company 22667 INSURED MOlson Coors Brewing Company 1030130 Coors Energy Company 311 10th St., Suite 400 Golden, CO 80401 INSURER B: OGLG25700983 INSURER C: 11/1/2015 INSURER D: 2,000,000 INSURER E: DAMAGE TO RENTED PREMISE Ea occurrence INSURER F: X 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 IN SD SUBR POLICY NUMBER POLICY EFF MM /DD POLICY EXP MM /DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR Vendors N N OGLG25700983 11/1/2014 11/1/2015 EACH OCCURRENCE 2,000,000 DAMAGE TO RENTED PREMISE Ea occurrence XXXXXXX X MED EXP An one person) 5,000 X SIR PERSONAL & ADV INJURY $ 2,000,000 .4',100 -000 GENT AGGREGATE LIMIT APPLIES PER POLICY❑ jE F—] LOC OTHER GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY 'V ANY AUTO AUT OWNED SCHEDULED AUTOS NON OWNED X HIRED AUTOS X AUTOS N N CALHO8610319 11/1/2014 11/1/2015 Ea eBcldeDtSINGLE LIMIT $ 2,000,000 BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident $ xxxxxxx PROPERTY DAMAGE Per accident $XXXXXXX $XXXXXXX UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX AGGREGATE $ XXXXXXX DIED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PRO PRIETOR/PARTNER/EXECUTIVE E-1 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) f yes descnbe under DESCRIPTION OF OPERATIONS below N/A / A NOT APPLICABLE PER STATUTE E L EACH ACCIDENT V V $ XXXXXXX E L DISEASE - EA EMPLOYEE v�� XXXXXXX E L DISEASE - POLICY LIMIT XMXAMn DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Keenesburg Mine po)( 1 Q4 1014 DIVICSICN OF RECLA�,IATION 1,1IIMNG Nt D SAFETY .Il idIrfL\■id- lAgH.1 1439971 Colorado Division of Reclamation Mining and Safety 1313 Sherman Street, Room #215 Denver CO 80203 Amon lie 1)n4A1n41 \Ct 16 \--0 2-b SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PRESENTATIVE r& "/C I C 3c 1–RR12014 ACORD CORPOF Tho ArnRn nnmo =nA Inn^ oro roniafororl mmrlra ^f ArnRn All riahts reserved