2015-09-14_GENERAL DOCUMENTS - C1981025

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C I ie nI 123725 SBHOLDINI ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDI IYYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 1 9/14/2015 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 NAME, Betsy Mease HUB International Ins Svcs Inc PHONE 303-382-5177 FAX 866-243-0727 AIC No Ext): AIC I 2742 Crossroads Blvd E-MAIL y• ADDRESS: bets urease hubinternational.com Grand Junction, CO 81506 09101/2016 EACH OCCURRENCE $1,000,000 INSURERS}AFFORDING COVERAGE NAIC# 888 245-8011 INSURERA: Employers Mutual Casualty Compa 21415 INSURED INSURER B : PREMISESa oacu ante S & B Holdings LLC CLAIMS -MADE I—XI OCCUR Minrec Inc INSURER C 627 24112 Rd Unit H INSURER D PERSONAL & ADV INJURY $15000,000 Grand Junction, CO 81505 INSURER E: INSURER FHUB CA License # 0757776 COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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 TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDI POLICY EXP MMIDI LIMITS A GENERAL LIABILITY 3X6490416 9/01/2015 09101/2016 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISESa oacu ante $500,000 CLAIMS -MADE I—XI OCCUR MED EXP (Any one person) $105000 PERSONAL & ADV INJURY $15000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2,000,000 POLICY PROJECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident BCD I LY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Peraccident $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB DED RETENTION $ $ WORKERS COMPENSATION WC STATU- TORYLIMITS OTH- ER AND EMPLOYERS' LIABILITY Y f N ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBEREXCLUDED? ❑ NIA E.L. EACH ACCIDENT $ 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 (Attach ACORD 907, Additional Remarks Schedule, if more space is required) Re: North Thompson Creek Mines, DRMS Permit C-1981-025. State of Colorado, Division of Reclamation Mining & Safety is included as an Additional Insured. 30 days notice of cancellation is provided. CERTIFICATE HOLDER CANCELLATION State of Colorado Division of Reclamation Mining & Safety 1313 Sherman St, Rm #215 Denver, CO 80203 ACORD 25 (2010/05) 1 of 1 #S36763761M3676373 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 _ �i © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD BM03