2018-07-31_GENERAL DOCUMENTS - C1981019

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ACV"�R �® ll`_/CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 07/24/2018 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 CONTACT Tim Johnstad or Lacey Skalicky NAME: Hays Companies PHONE 612-333-3323 FAX 612-373-7270 C No Ext): AIC, No (AC, E-MAIL tjohnstad@hayscompames corn ADDRESS: 80 S 8th Street INSURER(S) AFFORDING COVERAGE NAIC # Suite 700 INSURERA: Arch Insurance Company 11150 Minneapolis MN 80234 INSURED INSURER B: ACE Property & Casualty Insurance Co 20699 INSURERC: Elk Ridge Mining and Reclamation LLC INSURER D: 1100 West 116th Avenue INSURER E: INSURER F: Westminster CO 80234 COVERAGES CERTIFICATE NUMBER: 2018-2019 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 ADDLSUBR INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR DAMAGE100,000 PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL &ADV INJURY $ 1,000,000 A EP01004502-02 08/01/2018 08/01/2019 GEN'LAGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY ECT ® LOC f3s: Ep PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY (Per person) $ ANY AUTO 2018 OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY p��rsion of ReC �amation, n9 & Safety BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 25,000,000 AGGREGATE $ 25,000,000 B EXCESS LIAB CLAIMS -MADE 628145160 003 08/01/2018 08/01/2019 DED I RETENTION $ 25,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE❑ OFFICER/MEMBER EXCLUDED N / A E L EACH ACCIDENT $ (Mandatory in NH) DISEASE - EA EMPLOYEE S If yes, describe under DESCRIPTION OF OPERATIONS below _EL EL DISEASE - POLICY LIMIT $ 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 Colowyo Coal Company L P (Permit #C-81019) Includes use of Explosives CERTIFICATE HOLDER CANCELLATION Colorado Mined Land Reclamation Mined Land Division 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 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD