2017-08-01_GENERAL DOCUMENTS - C1980007

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ACOR& CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDDNYYY) 16%� 7/31/2018 7/26/2017 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 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 Three City Place Drive, Suite 900 St. Louis MO 63141-7081 (314) 432-0500 UO NAME: TA -UT PHONE AIC No Ext' AIC No E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE AIC # INSURERA: National Union Fire Ins Co Pitts. PA 19445 INSURED Mountain Coal Company LLC 1369402 P.0 Box 591 Somerset CO 81434 INSURER B : INSURERC: INSURERD, IN RER E INSURERF, COVERAGES ARCCO CERTIFICATE NUMBER: 12471681 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 INSD SUBR WVD POLICY EFF POLICY NUMBER MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY N N GL0936111 7/31/2017 7/31/2018 EACH OCCURRENCE 5,000,000 CLAIMS -MADE a OCCUR PREMISES (Ea RENTED ) 12,000,000 MED EXP (Any oneperson) 10,000 X XCU & Subsidence PD X Policy Gen AGG S25M PERSONAL & ADV INJURY $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY PRFX LOC GENERAL AGGREGATE $ 10,000,000 PRODUCTS - COMP/OP AGG $ 5,000,000 $ OTHER I I AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUAUTOS ONLY AUTOS TOS ONLY NON -OWNED ONL� 18 n'1$r1 N T APPLICNi$ PUNIC N ary $@SI STATE OF MIS URI St. LOUIS Co My Commission Expires: N vemger 12 2018 COMBINED SINGLE LIMIT Ea accident $ XXXXXXX BODILY INJURY (Per person) $XXXXXXX BODILY INJURY (Per accident $ X�{�{X'}��{X' PerraccldenDAMAGE $ XXXXXXX UMBRELLA LIAB OCCUR EACH OCCURRENCE $ XXXXXXX EXCESS LIAB CLAIMS -MADE NOT APPLICABLE AGGREGATE $XXXXXXX DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N OFFICERMIEM ER EXCLUD DF'(ECUTIVE 7_1N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below / A NOT APPLICABLE PER OTH- STATUTE ER E L EACH ACCIDENT $ XXXXXXX E L DISEASE - EA EMPLOYEE XXXXXXX E L DISEASE - POLICY LIMIT S XXXXXXX DESCRIPTION OF OPERATIONS I LOCATIONS I 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. PERMIT #C 1980007 WEST ELK MINE liLRllt"IVNI G W-_ li/11YliCLLN I IVIY ICC HLLaCl1111C11L 12471681 COLORADO DEPT. OF NATURAL RESOURCES DIVISION OF RECLAMATION, MINING & SAFETY 1313 SHERMAN STREET, ROOM 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. ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD