2017-10-16_PERMIT FILE - C1981019A

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A CERTIFICATE OF LIABILITY INSURANCE DATE CERTIFICATE 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 Tull JOhnstad -NAME- PHONE , (612)333-3323 ac No 612-373-7270 ADDRESS tjohnstad@hayscompanies.com INSURER(S) AFFORDING COVERAGE NAIC# INSURER Arch Insurance Company 11150 INSURED Elk Ridge Mining and Reclamation, LLC 1100 West 116th Ave Westminster CO 80234 INSURER B ACE Property S Casualty Ins CO 20699 INSURER C. INSURER D INSURER E: _ INSURER 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 UBR POLICY NUMBER M/DDNYYY MMIDDIYYVI'1 LIMITS $ COMMERCIAL GENERAL LIABILITY EACH OCCUPPENCE $ 1,000,000 A _ _ _ CLAIMS -MADE $ OCCUP AMAI $ 100,000 _PPEMISES (Ea occurrencej_ _ _ EP01004502-01 8/1/2017 8/1/2018 MED EXP (Any one person) $ PEPSONAL B ADV INJUPY $ 1,000,000 GEN'L AGGPEGATE LIMIT APPLIES PEP GENEPAL AGGPEGATE $ 2,000,000 POLICY n JECOT (s I LOC PPODUCTS_Comp/op AGG $ 2,000,000 � — - -- _ - - OTHEP $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea acc den BODILY INJUPY (Per person) $ ANY AUTO BODILY INJUPY (Per acclden) $ ALL OWNED SCHEDULED AUTOS AUTOS PPeOr PEPTY DAMAGE $ NON -OWNED HIPED AUTOS AUTOS $ $ UMBRELLA LIAB g OCCUP EACH OCCUPPENCE $ 25,000,000 AGGPEGATE $ 25 000,000 B E=LIAB CLAIMS -MADE DED S PETENTION$ 25,000 $ 628145160 002 8/1/2017 8/1/2018 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PPOPPIETOP/PAPTNEP/EXECUTIVE I PEP OTH- STATUTE EP EL EACH ACCIDENT $ OFFICEP/MEMBEP EXCLUDED'�f NIA E L DISEASE - EA EMPLOYEE_$ (Mandatory in NH) If yes, describe under DESCPIPTION OF OPEPATIONS below E L DISEASE - POLICY LIMIT 1 $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Evidence of Insurance as respects Coloxyo Coal Company, L.P. (Permit #C-81019). Includes use of Explosives CERTIFICATE HOLDER CANCELLATION ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 — m , Exhibit 3-1 Revision Date: 10/2/17 Revision No.: MR -180 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Colorado Mined Land Reclamation Mined THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Land Di.viLsi.On ACCORDANCE WITH THE POLICY PROVISIONS. 1313 Sherman Street, RM 215 AUTHORIZED REPRESENTATIVE Denver, CO 80203 James Hays/TJOHNSZ---��--"'��-'-'� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 — m , Exhibit 3-1 Revision Date: 10/2/17 Revision No.: MR -180