2015-06-08_GENERAL DOCUMENTS - C1983059

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ACO/?O® � CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 06/01/2015 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 Aon Risk Services, Inc of Florida 222 Lakeview Avenue CONTACT NAME: Iwc.No.Ext: (866) 283-7122 (800) 363-0105 Suite 510 West Palm Beach FL 33401 USA E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Zurich American Ins Co 16535 Oxbow Mininq. LLC 1601 Forum Place INSURER B: American Guarantee & Liability Ins Co 26247 INSURER C: Suite 1400 West Palm Beach FL 33401-8101 USA INSURER D: General Liablity SIR applies per policy terms INSURER E: INSURER F: nr $1,000,000 PRFMIRFC (F,T=) GUVtRAGES CERTIFICATE NUMBER: 570057863824 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. Limits shown are as requested INSR LTR TYPE OF INSURANCE ADDL INSD YV110 RI POLICY NUMBER POLICY rt -F6 fMKIDD PGUCYhxp lmmmoryml LIMITS A X COMMERCIAL GENERAL LIABILITY GLOUZb594905 EACH OCCURRENCE $2,000,000 ;� CLAIMS -MADE I X OCCUR �u General Liablity SIR applies per policy terms &conditions nr $1,000,000 PRFMIRFC (F,T=) MED EXP (Any one person) S10,000 PERSONAL &ADV INJURY $1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $10,000,000 POLICY 0JECT ❑X LOC II PRODUCTS-COMP/OP AGG $2,000,000 OTHER: A AUTOMOBILE LIABILITY BAP 9265950-05 Business Automobile cover 06/01/2015 06/01/2016 COMBINED SINGLE LIMIT $1,000,000 (Ee sccidenll BODILY INJURY ( Per person) X ANY AUTO ALL OWNED SCHEDULED BODILY INJURY (Per accident) AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) B X UMBRELLA LIAB X OCCUR AUC926593705 05/01/2015 06/01/2016 EACH OCCURRENCE $25,000,000 EXCESS LIAR CLAIMS -MADE Umbrella AGGREGATE $25,000,000 DED X RETENTION$10, 000 WORKERS COMPENSATION ANDER EMPLOYERS' LIABILITY YIN ANY PROPRIETOR I PARTNER I EXECUTIVE OTH. CTATI ITF PR E.L. EACH ACCIDENT OFFICERIMEMBER EXCLUDED? Ll I A E.L. DISEASE -EA EMPLOYEE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Permit number C - 1983-059 " Terror Creek Loadout " Division of Reclamation, Mining and safety is included as Additional Insured as required by written contract, but limited to the operations of the Insured Under said contract, per the applicable endorsement with respect to the Auto, GL and UMB policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE VNTH THE POLICY PROVISIONS. Division of Reclamation, Mining AUTHORIZED REPRESENTATIVE and Safety Sherman street, Room 215 Denver !i Qr.�� Denver Co 80203 USA ✓C� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD