2016-07-25_REVISION - C1996083 (25)

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80WIE-1 OP ID: BH CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYYJ 02101!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 pELOW. 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 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). _ RODUCER $ lorsvilie Road 330 Tay lorsville Rd :Iiuisville, KY 40220 obert P. Wessel, Jr. CPCU ISURED Bowie Resource Holdings, LLC Jim Wolff 6100 Dutchman's Lane Ste 900 Louisville, KY 40205 CONTACT NAME; Robert P. Wessel, Jr. CPCU ___ PHONE 502-493-2370 0:502-493-2320 C No Exti: _ E-MAIL ADDRESS: -- INSURER($) AFFORDING COVERAGE _ HAIC # _ INSURER A: National Union Fire _ 19445 INSURER B:Lexington Insurance Company iuciroce c •Aoollo Insurance ENSURER E : INSURER F ; .f%%J OA^00 r_Gprlclr`ATF MI1MBER- REVISION NUMBER: rWV VimmWiwV 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. R TYPE OF INSURANCE POLICY NUMBER P DOY F EXP P DD NYYYI LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,00 DAMPREMISES Es oecurrenee ENTEU $ 1,000,00 CLAIMS -MADE a OCCUR GL 6676428 02/0112016 02101/2017 MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGRE GATE LI MIT APPLIES PER: GENERAL AGGREGATE $ 3,000,0 00 PRODUCTS - COMPIOP AGG $ 2.000, POLICY [] PRO- F LOC Emp Ben' $ 1,000,000 JECTON OTHER ED SINGL = Ea accEden TOMOBILE LIABILITY BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per acddent) $ ALL OWNED SCHEDULED AUTOS AUTOS ED PROPERTY AG $ (Per HIREDAUTOS AUTOS $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 10,000,00 AGGREGATE $ EXCESS LIAR CLAIMS -MADE BE84160078 02/01/2016 02101/2017 DED I X I RETENTION 10000 $ WORKERS COMPENSATION ER STATUTEI ER AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR/PARTNERIEXECUTIVE E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ OFFICERIMEMBER EXCLUDED? � (Mandatory in NH) N /A E.L DISEASE -POLICY LIMIT $ I( yea deeuibe under DESCRIPTION OF OPERATIONS below Excess Umbrella 25267262 02/01/2016 02101/2017 Excess 15,000,00 Umbrella -ESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be atteched If more space Is regoree) vidence of Insurance as respects to Bowie #2 Mine Permit #C1996083 and owie #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. State of Colorado Department of Natural Resource Div. of Minerals & Geology 1313 Sherman St, Room 215 Denver, CO 80230 STATECO 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 P*94rl- k/011Ak ®1988-2014 ACORD CORPORATION, All rights reserved. %CORD 25 (2014101) The ACORD name and logo are registered marks of ACORD