2017-10-31_PERMIT FILE - C1981008A (4)

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mm .�oRd CERTIFICATE OF LIABILITY INSURANCE °7/11/31MGD /20177 1 7 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: N the artlSeab hailer Is an ADDITIONAL INSURED, the poSWks) must be endorsed. N SUBROGATION IS WAIVED, Subject to the terms and andldoos of the policy, certain policies may ?Squire an endorsement. A statement on We certificate does not confer rights to the certificate holder In ileu of such endorsems s . INIOOUC6l Hays 00 80 8 8th Street finite 700 Minneapolis NN 55402 Tim Jobnstad PHONE (612)333-3323 612-373-7270 tjohnstadhayacardlanies.con IMMERMAFFglosrS COVERAGE rake arwOWA-ArCh XUBUICaace COMPAW 11150 SMatED Elk Ridge Mining and Reclamation, LLC 1100 Nest 116th Ave Westminster CO 80234 amunaaaAC6 Property & Casualty Ins Cc 20699 ONLIM C: e1eLa O: MM1RME: RPOIQ04502-01 COVERACIRIt CERTFICATE MIIM111ER4017-20111 REVISION ML1 R - 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. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TVPB OF NISL n"=POLICY THE EXPIRATION DATE THMUDF, NOTICE WILL BE DELIVERED IN Division of Reclamation, Mining i Safety ACCORDANCE WITH THE POLICY PROVISION& ON % ALmNNa3D VAPRESENTATIVE Lem >, X es1HEIp4kL-D Al LIABILITY CLAIMSYADE ❑T OCCUR RPOIQ04502-01 6/1/2017 6/1/2010 EACH OC CUF4 34CE S 1, 000, 000 S 100,000 MED EXP ae $ PERSONAL& ADV INJURY f 11000,000 GEWL AGGREGATELIMITAPPLIES PER POLICY ElT O LOC OTHER GENERAL AGGREGATE $ 2,000,000 PRODUCTS -CO3PAIP AGO $ 2,000,000 $ AVTOMOaRE LIABILITY ANY AUTO ALL OWNED SC/EOULED AUTOS AUTO$ HIRED AUTOS NOAUTOS4Y WNED Mrr & ODDLY V41URY(Par paean) S BODLYINMRY(PwaodOall) S Y S s B X Lips LIAS X OCCUR CWM54AADE 025165160 002 11/1/2017 S/1/2011 EACH OCCURRENCE S 25,000,000 AGGREGATE $ 25.000.000. = I RETENTIONS 25.000 $ AND E els C01P0 IAINUE 1 AND EIlLO110m' lIAaILITY ANY PAOPRIETORIP�E YIN OFFICE#AIFAIER EXCLUDED? -1 pllyeaaa6W,bry In MQ DEBCRIPTgN OPERATIONS below NIA � E.L. EACH ACCIDENT $ E.L. DISEASE • EA EMPLOYEES F -L DISEASE - POLICY LAST S DL9CItlFT10M OF OPMATONe I LOCATONSI VWWM (ACORD 1101, AdMorAl Ranakl Sdo*A%slay N saadad Baca apace Y neeaq Evidence of insurance as respects New Horizon Horth Nine in Nucla, CO (Permit #C-2010-089) and New Horizon Mine (Permit #C-81-008). Includes explosives. i r`CfrY7MATC MAI non CAML:FI 1 ATIrw6 01868-2014 ACORD CORPORATION. All rights reserved. ACORD 23 (2011/01) The ACORD name and logo am registered marks of ACORD INS02517nun+H Attachment 2.03.9-1 Page 2 October 2017 (MR -106) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Colorado Mined Land Reclamation Hoard THE EXPIRATION DATE THMUDF, NOTICE WILL BE DELIVERED IN Division of Reclamation, Mining i Safety ACCORDANCE WITH THE POLICY PROVISION& 1313 Sherman Street, RM 215 ALmNNa3D VAPRESENTATIVE Denver, CO 80203 James Hays/TJOHNS 1 01868-2014 ACORD CORPORATION. All rights reserved. ACORD 23 (2011/01) The ACORD name and logo am registered marks of ACORD INS02517nun+H Attachment 2.03.9-1 Page 2 October 2017 (MR -106)