2015-06-02_GENERAL DOCUMENTS - C1981004

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ACORO° CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DD/YYYY) 111.� 6/1/2016 1 5/28/2015 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 Three City Place Drive, Suite 900 St. Louis%O 63141-7081 (314) 432-0500 CONTACT N P FAX A/c No Ext): A/c No): E-MAIL ° N GL1903168 IN AFFORDING COVERAGE N I # INSURER A : National Union Fire Ins Co Pittsburgh PA 19445 C E'V INSURED Rhino Resource Partners, LP INSURER B: Lexinaton Insurance Cowany 19437 1340392 PO Bx evillelKY41502 JUN 0 �I ZM INSURER INSURER D: GENERAL AGGREGATE $ 2,000,000 MUSURER DIMSION 9,F RECLMA ATI J INSURER F AUTOMOBILE LIABILITY X ANY AUTO ALL SS NED SCHEDULED AUTOS NON -AWNED HIRED AUTOS AUTOS COVERAGES R14IRE CERTIFICATE NUMBER: 11319112 REVISION NUMBER: XXXJY—XX 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 LTIR TYPE OF INSURANCE ADDL INSD SUBR Wyp POLICY NUMBER POLICY EFF M / POLICY EXP M /DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR N N GL1903168 6/1/2015 6/1/2016 EACH OCCURRENCE 1,000,0 0 PREMISES ERENTED occur ence 1,000,000 MED EXP (Any oneperson) 10,000 PERSONAL & ADV INJURY $ 1,000,000 FG—ENT AGGREGATE LIMIT APPLIES PER POLICY JE LOC OTHER GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG $ 2,000,000 1 $ A AUTOMOBILE LIABILITY X ANY AUTO ALL SS NED SCHEDULED AUTOS NON -AWNED HIRED AUTOS AUTOS N N CA5775970 6/1/2015 6/1/2016 Ee aocld DtSINGLE LIMIT $ 1000,000 BODILY INJURY (Per person) $ XXY�YXYM BODILY INJURY (Per accident $ALIXXXXXXX PROPERTY DAMAGE $ XXXxCXX Per accident $XXXXXXX B X UMBRELLA LIABX EXCESS LIAB OCCUR CLAIMS -MADE N N 013136615 6/1/2015 6/1/2016 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED I I RETENTION $ Prod Comp Ops $ 5,000,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) nbe under DIf ESCRIPTION OF OPERATIONS below N / A NOT APPLICABLE PER OTH- STATUTE I EEL `7�T E L EACH ACCIDENT $ XxxXxXX `7V E L DISEASE - EA EMPLOYEE VXXXXXJx E L DISEASE - POLICY LIMIT XX�X DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required) NAMED INSURED INCLUDES MCCLANE CANYON MINING, LLC. MCCLANE CANYON MINE, PERMIT NO. C-1981-004 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 11318132 DIVISION OF RECLAMATION MINING & SAFETY 1313 SHERMAN ST. ROOM #215 DENVER, CO 80203 ACORD 25 (2014/01) ©1988--2&WACC The ACORD name and logo are registered marks of ACORD All rights reserved