2016-08-01_GENERAL DOCUMENTS - C1980007

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ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MWDD/YYYY) `� 7/31/2017 7/26/2016 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(les) must have ADDITIONAL INSURED provisions or 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 CO NACT Three City Place Drive, Suite 900 PHONE FAX A/C No St. Louis MO 63141-7081 E-MAIL (314)432-0500 RECEIVED ADDRESS: 7/31/2017 EACH OCCURRENCE $ 5 OOO 000 INSURERS AFFORDING COVERAGE NAIC # INSURER A: National Union Fire Ins Co Pitts. PA 19445 INSURED ~- Mountain Coal Company LLC 1369402 INSURER B: P.0 . O. Box 591 DIVISION OF RECLAMATION INSURER C: INSURER D Somerset CO 81434 MINING AND SAFETY X Policy Gen AGG $25M INSURER E: INSURER F: I:VVCHAULb AKUUU LOCM 11rIUA I t NUMOCM: 124/ 10251 111tviblum NUMCtFi: 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 OF INSURANCE ADDLTYPE IM& SUER POLICY NUMBER MPOLICY D/D/YYYY XP YYY MM/DDN LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR N N GL0936111 7/31/2016 7/31/2017 EACH OCCURRENCE $ 5 OOO 000 DAMAGETE ccurrence $ 2,000,000 PREMISES Ea occurrence) MED EXP (Any one person) $ 10,000 X XCU & Subsidence PD PERSONAL & ADV INJURY $ S 000 000 X Policy Gen AGG $25M GEN'L AGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE $ 10,000,000 POLICYFX EC LOC El J PRODUCTS -COMP/OP AGG $ S 000 000 AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA UAB OCCUR EXCESS LIAB HN AMR WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? � N / A (Mandatory in NH) If ves. describe under NOT APPLICABLE NOT AF NOT Stephanie L. Klearman Notary Public - Notary Seal STATE OF h IISSOURI St. Louis ounty Commission #14966528 1 E� aBadeDtSINGLE LIMIT $XXXXXXX BODILY INJURY (Per person) Is XXXXXXX BODILY INJURY (Per accident) $ XXXXXXX PROPERTY DAMAGE $XXXXXXX Per accident $XXXXXXX EACH OCCURRENCE E.L. EACH ACCIDENT 1 $ E.L DISEASE - EA EMPLOYEE $ E L. DISEASE - POLICY LIMIT I $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) COVERAGE IS INCLUDED FOR SURFACE COAL MINING AND RECLAMATION OPERATIONS INCLUDING THE USE OF EXPLOSIVES. C-80-007 WEST ELK MINE 12471681 COLORADO DEPT. OF NATURAL RESOURCES DIVISION OF RECLAMATION, MINING & SAFETY 1313 SHERMAN STREET, ROOM 215 DENVER CO 80203 ELLA 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 W IV00-LV IV IiVVnLJ %.Vnr-VnM I IVIV. IMII llylittl IVZOI[VCV. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD