2015-01-14_GENERAL DOCUMENTS - C1981035

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CERTIFICATE OF LIABILITY INSURANCE DATE(OD'/YYY1� 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(les) must be endorsed. ff 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 endomement(s). PRODUCER Aon Risk Services southwest, Inc. Houston TX Office CONTACT NAME. A/C. No. Eat): (866) 283 -7122 FX No.): (800) 363 -0105 E-MAIL ADDRESS: 5555 San Felipe suite 1500 Houston TX 77056 USA O INSURER(S) AFFORDING COVERAGE NAIL Y INSURED v GCC LLC v ,J 6473 County Road 120 �j� �� Hesperus Co 81326 USA G\a(�� INSURER A: American Zurich ins Co 40142 INSURER B: Zurich American ins Co 16535 INSURER C: Liberty Insurance Underwriters, Inc. 19917 INSURER D: $10,000 INSURER E: INSURER F: $1,000,000 COVERAGES CERI n N BER: 570055459613 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OWUMANCE 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 N ADOL p POUCY NUMBER LIMITS X COMMERCIAL GENERAL LIABIL" CLAIMS -MADE X❑OCCUR GLO EACH OCCURRENCE $2.000,000 PREMISES a6 RED $1,000,000 MED EXP (Any one person) $10,000 PERSONAL B ADV INJURY $1,000,000 GEML AGGREGATE UMrrAPPUESPER X POLICY ❑JE4 �LOC OTHER GENERALAGGREGATE $4,000,000 PRODUCTS- COMP/OP AGG $4,000,000 B AUTOMOBILE LIABILITY AI NYAUTO X ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON-OWNED AUTOS $1000 Coll Ded $1000 Comp Ded HAP65 5124205 09/01/2014 09/01/2015 COMBINED SINGLE LIMIT Es accidenn $1,000,000 BODILY INJURY ( Per person) BODILY INJURY (Per accident) ROPE accident) C X UMt3RELLALIAB EXCESS LIAR X OCCUR CLAIMS -MADE 100005937504 09/01/2014 09/01/2015 EACH OCCURRENCE 25, 00 , 000 AGGREGATE $25,000,000 OEO I RETENTION B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR / PARTNER / E)MCUTIVE YIN OFFICER/MEMBER EXCLUDED7 N (Mandatory in NH) H yes, describe under DESCRIPTION OF OPERATIONS below NIA WC65 1 4 09/01/201T -OT/-0172-617 X PER STATUTE ERH- E.L. EACH ACCIDENT $2,000,000 EL DISEASE -EA EMPLOYEE $2,000,000 E.L. DISEASE - POLICY LIMIT $2,000,005 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached I more space is required) see Attached: CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS Colorado Division of Reclamation, AUTHORIZED REPRESENTATIVE Mining & Safety 1313 Denver Sherman street, Room 215 c y/f e41 Ial; YM 1JL Denver CO 80203 USA 01988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD m C m 0 ro W O O n 0 Z aIBr m v