2016-06-07_GENERAL DOCUMENTS - C1980004

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ACC>R6' CERTIFICATE OF LIABILITY INSURANCE 166� 6/1/2017 F DATE(MM/DD/YYYY) 1 5/27/2016 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 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 900HO St. Louis MO 63141-7081 (314) 432-0500 NTCT NAME: E Ext): FAX A/C No E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: National Union Fire Ins CO Pitts. PA 19445 INSURED Rhino Resource Partners, LP 1340392 PO Box 1169 Pikeville KY 41502 INSURER B: Lexinpton Insurance Company 19437 INSURER C INSURER D: INSURER E: IN URER F : COVERAGES RHIRE CERTIFICATE NUMBER: i i 318132 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 HAVE BEEN REDUCED BY PAID CLAIMS INSR LTR TYPE OF INSURANCE ADDL IND SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR N N GL1903168 6/1/2016 6/1/2017 EACH OCCURRENCE 1,000,000 DAMAGE TO oNcurDence 1,000,000 MED EXP An one person)10,000 _ PERSONAL & ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER _ POLICY❑ PRO- LOC OTHER GENERAL AGGREGATE $ 2,000,000 _ PRODUCTS -COMP/OP AGG $ 1000,000 $ A AUTOMOBILE LIABILITY X ANY AUTO AUTOS NED AUTOSULED NON -OWNED HIRED AUTOS AUTOS Ni N CA5775970 6/1/2016 6/1/2017 (CEO,a..d.ntSINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident $ )L'XXXXyX PROPERTY DAMAGE $ XXXXXXX Per accident $XXXXXXX B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE N N _ 013136615 6/1/2016 6/1/2017 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) If yes, describe under DESCRIPTION OF OPERATIONS below NIA NOT APPLICABLE PER OTH- STATUTE E L EACH ACCIDENT $ XXXXXXXX XXXXXXX E L DISEASE - EA EMPLOYEE XXXXXXX V V vV V E L DISEASE - POLICY LIMIT XXXXXXX DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is re r NAMED INSURED INCLUDES MCCLANE CANYON MINING, LLC MCCLANE CANYON MINE, PERMIT NO. C-1981-00 v ,SUN 0 12016 DN1MIOF RECLAMAT10" � NG AND WETYY VCR I Iri%,m 1 C r1VLUCR k.ANt rLLAI IVIV 11318132 DIVISION OF RECLAMATION MINING & SAFETY 1313 SHERMAN ST. ROOM #215 DENVER, CO 80203 ACORD 25 (2014/011 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 ©1 The ACORD name and logo are registered marks of ACORD N. All rights reserved