2017-10-18_GENERAL DOCUMENTS - C1981010

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i 10DATE lila D CERTIFICATE OF LIABILITY INSURANCE (MM/DD/YYYY) 10/10/2017 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(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 MARSH USA INC. 122517TH STREET, SUITE 1300 DENVER, CO 80202-5534 Attn: Denver.CerlReques@marsh.com / FAX 212-948-4381 CONTACT NAME: PHONE FAX A/C No): E-MAIL ADDRESS: INSURERIS) AFFORDING COVERAGE NAIC # INSURER A: Federal Insurance Company 20281 S67982 -00125 -ALL -17-18 INSTRAPPER MINING INC. PO BOX 187 INSURER B: NIA NIA INSURER C : ACE PrDperty And Casualty Ins Co - 20699 INSURER D CRAIG, CO 81626 INSURER E: L11A PRODUCTS - COMP/OP AGG $ 2,000,000 INSURER F: CnVFRAGFS CERTIFICATE NUMBER_ SEA -003351588-41 REVISION NUMBER: 7 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 AD L SUBR IL POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE MOCCUR of Marsh USA Inc. 35907412 CEIVED REPERSONAL pCT 18 2011 10/01/2017 10/01/2018 EACH OCCURRENCE $ 1,000,000 DAMAGETO R N PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 10,000 & ADV INJURY $ 1'000'000 GEN'L AGGREGATE LIMIT APPLIES PER X POLICY JECT 1:1 LOC OTHER GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ AUTOMOBILELUIBILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY pivision of ReC131 Alining & Safety COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per ant X UMBRELLALIAB EXCESS LIAB X OCCUR CLAIMS -MADE XOO G27908755 003 10/01/2017 10101/2018 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 DED I X RETENTION s25,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE ❑N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A STATUTE ER E L EACH ACCIDENT $ E L DISEASE - EA EMPLOYEE $ E L DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) RE: PERMIT#C-81-010 POLICY INCLUDES COVERAGE FOR PROPERTY DAMAGE AND PERSONAL INJURY RESULTING FROM THE USE OF EXPLOSIVES. CFRTIFICATF H11711 PFR CANCELLATION COLORADO DIVISION OF RECLAMATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE AND SAFETY DEPARTMENT OF NATURAL RESOURCES THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1313 SHERMAN STREET - ROOM 215 ACCORDANCE WITH THE POLICY PROVISIONS. DENVER, CO 80203 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Jon Lindstrom ©1988-2015 ACORD CORPORATION. All rignts reservea. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD