2016-06-07_GENERAL DOCUMENTS - C2010088

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ACORO° CERTIFICATE OF LIABILITY INSURANCE 6/1/2017 DATE(MM/DD/YYYY) 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 900E St. Louis MO 63141-7081 (314) 432-0500 CONTACT NAME: FAX A/c, Ext): A/C No E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: National Union Fire Ins Co Pitts. PA 19445 INSURED CAM Colorado, LLC 1340392 PO Box 1169 Pikeville KY 41502 INSURER B: Lexington Insurance Company 19437 INSURER C INSURER D: INSURER E : INSURER F: COVERAGES RHIRE CERTIFICATE NUMBER: 12139435 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 NSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS-MADEFX I OCCUR Y N GL1903168 6/1/2016 6/1/2017 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED 1 OOO 000 PREMISES Ea occurrence MED EXP (Any oneperson) 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY JE� � LOC OTHER GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY X ANY AUTO AUTOS NED SCHEDULED AUTO NON -OWNED HIRED AUTOS AUTOS N N CA5775970 6/1/2016 6/1/2017 COMBINED SINGLE LIMIT Ea acadent $ 1,000,000 BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident $ XXXXXXX 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 DEC) I I RETENTION $ Prod Comp Ops $ 5,000 000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ElN OFFICER/MEMBER EXCLUDED (Mandatory in NH) If yes, descnbe under DESCRIPTION OF OPERATIONS below / A I NOT APPLICABLE PEROTH- STATUTE I FIR 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: UNIT TRAIN LOADOUT DRMS PERMIT # C-2010-088 STATE OF COLORADO RECLAMATION AND SAFETY IS ADDITIONAL INSURED UNDER GENERAL LIABILITY WHERE REQUIRED BY WRITTEN CONTRACT vV) CERTIFICATE HOLDER 12139435 JUN � -� 2p16 DMS4p WOGRND Sp�EN N STATE OF COLORADO DIVISION OF RECLAMATION MINING AND SAFETY 1313 SHERMAN ST. RM#215 DENVER CO 80203 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 ACORD 25 (2014/01) ©1988-2&tkrACC The ACORD name and logo are registered marks of ACORD N. All rights reserved