2017-08-07_GENERAL DOCUMENTS - C2010089

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® DATE (MM/DDNYYY) AC� 11CERTIFICATE OF LIABILITY INSURANCE 7i31i2017 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 Hays Companies 80 S 8th Street Suite 700 Minneapolis MN 55402 CONTACT Tim Johnstad NAME: AICNNo Ext: (612) 333-3323 FAX No): 612-373-7270 E-MAIL t ohnstad@ha scorn anies.com ADDRESS: Y P INSURER(S) AFFORDING COVERAGE NAIC # INSURERAArch Insurance Company 11150 INSURED Elk Ridge Mining and Reclamation, LLC 1100 West 116th Ave Westminster CO 80234 INSURER B ACE Property & Casualty Ins Co 20699 INSURER C: INSURER D: INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER:2017-2018 REVISION NUMBER: 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 I SUBR POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE ❑X OCCUR DAMAGE ToR PREM SES E oN uErDence $ 100,000 MED EXP (Any one person) $ EP01004502-01 8/1/2017 8/1/2018 PERSONAL &ADV INJURY $ 1,000,000, _ GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY F71PECOT- LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) NON -OWNED HIRED AUTOS AUTOS $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 25 000 000 AGGREGATE $ 25,000,000 B EXCESS LIAB CLAIMS -MADE DED X I RETENTION$ 25,000 $ G28145160 002 8/1/2017 8/1/2018 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE r OFFICER/MEMBER EXCLUDED? N / A EL EACH ACCIDENT $ - - - - - -- (Mandatory in NH) E L DISEASE - EA EMPLOYE $ If yes describe under DESCRIPTION OF OPERATIONS below E L DISEASE - POLICY LIMIT $ I i DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may beta(P s required) Evidence of insurance as respects New Horizon North Mine irisa, CO (Permit #C-2010-089) and New Horizon Mine (Permit #C-81-008). Includes explosives. L„ J;sion of ReCA30100tl, Mining & salty CERTIFICATE HOLDER CANCELLATION Colorado Mined Land Reclamation Board Division of Reclamation, Mining & Safety 1313 Sherman Street, 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 REPRESENTATIVE James Hays/TLJ0H1,1S © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025mm4mi