2016-05-17_GENERAL DOCUMENTS - C1981038

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BOWIE -1 n� OIC ID: BH ��'► CERTIFICATE OF LIABILITY" INSURANCE F DATE(MMIDDIYYYY, 02/01/2016 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 P;FLOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED RESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. JRTANT: if the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to tine terms and conditions of the policy, certain policies may require an endorsement. A statement on this rertificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONYAC'r RODUCER NAME: Obert P. Wessel, Jr. CICU E OTSViileRoad PHONE— ----ayyiorsvffieRd W No Ext :502 493_2370 - - - -�aricNo): 502 4932320sville, KY 40220 EMAIL nhart P Waasal .Ir CPCII ADDRESS: --------------- -------------_.._ ISURED Bowie Resource HOIdings, LL,C Jim Wolff 6100 Dutchman's Lane Ste 900 Louisville, KY 40205 'OVERAGES CERTIFICATE NUMBER: INSURER(S) AFFORDING COVERAGE NAIC A, National Union Fire 19445 B: Lexington Insurance Company INSURER C: Apollo Insurance INSURER E : INSURER F: 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. NOTVVITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT 1.0 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. ;1RTYPE OF INSURANCE POLICY NUMBER POLICY POLICY EXP R LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,00 PREMISES Ea occurrence $ 11000,000 CLAIMS -MADE 1,R] OCCUR GL 6676428 02/0112016 02/0112017 MED EXP (Anyone person) $ 10,00 PERSONAL& ADV INJURY $ 2,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 3,000,00 PRODUCTS - COMPIOP AGG $ 2,000,00 POLICY ] PRO- F7LOCJECT Emp Ben. $ 1,000100 OTHER TOMOBILE LIABILITY ED SINGL $ Ea accident BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE $ Per accident $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,00 AGGREGATE - $ EXCESS LIAR CLAIMS -MADE BE84160078 02/01/2016 02101/2017 DED I X I RETENTIONS 10000 $ WORKERS COMPENSATION STATUTE ER AND EMPLOYERS LIABILITY ANY PROPRIETORIPARTNEWEXECUTIVE Y E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N I A E.L DISEASE -POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below Excess Umbrella 025267252 02101/2016 02101/2017 Excess 15,000,00 Umbrella -ESCRIPTION OF OPERATIONS ! LOCATIONS 1 VEHICLES (ACORD 101, Additional Remark& Schedule, may be attached If more apace is required) vidence of Insurance as respects to Bowie #2 Mine Permit #C1996083 and owis #1 Mine Permit #C1981038. General Liability policy provides protection or use of explosives. The General Liability and Umbrella policies include n endorsement providing that 30 days notice of cancellation (or coverage hangs) will be furnished to the certificate holder by the carrier. 'ERTIFICATE HOLDER CANCELLATION STATECO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN State of Colorado ACCORDANCE WITH THE POLICY PROVISIONS. Department of Natural Resource Div. of Minerals & Geology AUTHORIZED REPRESENTATIVE 1313 Sherman St, Room 215 ))� ,, �) p, Denver, CO 80230 PJX11 Vli'a6aQJC. Ak ©1988-2014 ACORD CORPORATION, All rights reserved. CORD 26 (2014/01) The ACORD name and logo are registered marks of ACORD