2014-08-05_GENERAL DOCUMENTS - C1981008

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ACOR I �- CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 07/29/2014 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 1- 612- 333 -3323 Hays Companies O CONTACT ace NAME: Lacey Skalic ky PHONE FAX Al No Ex 5I5- 802 -3005 Arc No: 515 - 802 -3032 E -MAIL ADDRESS: lskalicky@hayscompanies.com 80 South 8th Street G`v Suite 700 Minneapolis, MN 55402 , INSURERS AFFORDING COVERAGE NAIL# INSURERA: LEXINGTON INS CO 19437 INSURED ````((�' Western Fuels- Colorado, LLC 1100 West 116th Avenue c\O`\ QF �OGC� ` Westminster, CO 80234M�N \NG INSURER B: NATIONAL UNION FIRE INS CO OF PITTS 19445 INSURER C: X COMMERCIAL GENERAL LIABILITY INSURER D: INSURERE: DAMAGE TO RENTED PREMISES Ea occurrence M INSURER F $ COVERAGES CERTIFICATE NUMBER: 40866829 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 MMIDD/Y YYY POLICY EXP MM /DD/YYYY LIMITS A GENERAL LIABILITY 021396066 08/01/1 08/01/15 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ CLAIMS -MADE F-il OCCUR PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OPAGG $ 2,000,000 $ POLICY PRO X LOC AUTOMOBILE LIABILITY A COMBINED SINGLE LIMIT Ea accdent BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ $ L 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 Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE WC STATU- OTH- Y LIMIT R E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT 1 $ If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Evidence of insurance as respects New Horizon North Mine in Nucla, CO (Permit #C- 2010 -089) and New Horizon Mine (Permit #C -81 -008). Includes explosives. Colorado Mined Land Reclamation Board Division of Reclamation, Mining & Safety 1313 Sherman Street, RM 215 Denver, CO 80203 ACORD 25 (2010/05) TOlmstead 40866829 USA t- /Ar4I,CLL1'11 IVN 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