2015-06-09_GENERAL DOCUMENTS - C1981020

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ACOREX CERTIFICATE OF LIABILITY INSURANCE lk*� 6/1/2016 DATE (MM/DD/YYYY) 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 MO 63141-7081 (314) 432-0500 CONTACT NAME: FAX A/C, No, Ext): AIC, No): E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: National Union Fire Ins Co Pittsburgh PA 19445 INSURED Rhino Resource Partners LP 1340392 CAM Mining LLC PO Box 1169 Pikeville KY 41502 INSURER B: Lexinl4ton Insurance Company 19437 INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES RHIRE CERTIFICATE NUMBER: 11291473 REVISION NUMBER: XXXXXXX 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 HAyf..B&LN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD NOLICY EFF M/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR N N GL1903 (� 201[ 3ON 09 J DIVISION NG AND 6/1/2015 �,�, 6/1/2016 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED 1,000,000 PREMISES Ea occurrence MED EXP (Any oneperson) 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PE E] LOC OTHER GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE X LIABILITY ANY AUTO AUTOS NED SCHEDULED AUTS NON -OWNED HIRED AUTOS AUTOS N N CA5775970 6/1/2015 6/1/2016 EO COMBINEDaccidenSINGLELIMIT $ 1,000,000 BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident $ XXXXXXX PROPERTY DAMAGE $XXXXXXX Per accident $XXXXXXX B X UMBRELLA LIABX EXCESS LIAB OCCUR CLAIMS -MADE ISI 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/MEMBH) EXCLUDED? (Mandatory in NH) If es, describe under DESCRIPTION OF OPERATIONS below N / A NOT APPLICABLEFR STATUTE OTH- E.L. EACH ACCIDENT $ XXXXXXX E.L. DISEASE - EA EMPLOYEE XXXXXXX E.L. DISEASE - POLICY LIMIT XXXXXXX DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: MUNGER CANYON MINE, DRMS PERMIT 1981-020 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. 11291473 AUTHORIZED REPRESENTATIVE DIVISION OF RECLAMATION MINING AND SAFETY 1313 SHERMAN STREET ROOM 215 DENVER CO 80203 ACORD 25 (2014/01) @1988_2&tn(f0RD_COM5_0RA'r1DN. All rights reserved The ACORD name and logo are registered marks of ACORD