2019-06-04_GENERAL DOCUMENTS - C1983059

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® A� o CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 05/31/2019 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 Aon Risk Services, Inc Of Florida 1001 Bri ckel l Bay Drive CONTACT NAME: AX (A/CNNo. Ext): (866) 283-7122 (A/C No.): (800) 363-0105 E-MAIL ADDRESS: Suite 1100 Miami FL 33131 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURERA: Zurich American Ins Co 16535 Oxbow Energv Solutions LLC 1601 Forum Place INSURER B: American Guarantee & Liability Ins Co 26247 INSURER C: Suite 1400 West Palm Beach FL 33401-8101 USA INSURER D: INSURER E: & conditions INSURER F: D $1,000,000 PREMISES Ea occurrence COVERAGES CERTIFICATE NUMBER: 570076444948 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 Limits shown are as requested INSR LTR TYPE OF INSURANCE ADDISUBIR INSD WVD POLICY NUMBER MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY GLO EACH OCCURRENCE $2,000,000 CLAIMS-MADEX❑ OCCUR SIR applies per policy terns & conditions D $1,000,000 PREMISES Ea occurrence MED EXP (Any one person) $10,000 PERSONAL &ADV INJURY $1,000,000 GENIAGGREGATE LIMITAPPLIES PER GENERAL AGGREGATE $4,000,000 POLICY E PRO a LOC JECT PRODUCTS - COMP/OP AGG $2,000,000 OTHER A AUTOMOBILE LIABILITY BAP 9265950-09 06/01/2019 06/01/2020 COMBINED SINGLE LIMIT $1,000,000 Ea accident BODILY INJURY ( Per person) X ANYAUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLYAUTOS X HIREDAUTOS X NON -OWNED ONLY AUTOS ONLY - D PROPERTYDAMAGE Per accident B X UMBRELLA LIAB X OCCUR AUC926593709 06/01/2019 06/01/2020 EACH OCCURRENCE $25,000,000 EXCESS LIAB CLAIMS -MADE �{ N ry A �O 9 AGGREGATE $25,000,000 DED X R $10,000 ETENTION WORKERS COMPENSATION AND.w EMPLOYERS' LIABILITY YIN •`�`d O PER OTH- STATUTE ER EL EACH ACCIDENT ANY PROPRIETOR/ PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N / A EL DISEASE -EA EMPLOYEE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERA IONS below E L DISEASE -POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Terror Creek LLC C-1983-059 Division of Minerals & Geology is included as an Additional insured as required by written contract but limited to the operations of the Insured under said contract, and always subject to the policy terms, conditions and exclusions. The General policy evidenced herein covers use of explosives. CERTIFICATE HOLDER CANCELLATION ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Division of Minerals & Geology AUTHORIZED REPRESENTATIVE 1313 Sherman Street Room 215 Denver co 80203 USA 'gem�y� � ,.cr%�� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD