2019-06-07_GENERAL DOCUMENTS - C1980004 (2)

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ACCORD' CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) kw-� 6/1/2020 5/31/2019 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(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED,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 Ileu f such endorsement(s). CONTACT PRODUCER Lockton Companies ®� NAME: Three City Place Drive,Suite 900PHONE ac No,Ext): A/c No St.Louis MO 63141-7081 19 E-MAIL (314)432-0500 0� �0 ADDRESS: INSURER(S)AFFORDING OVERA NAI NSURER A: Federal Insurance CornDany 20281 INSURED Rhino Resource Partners,LP INSURER B: Lexington Insurance Company 19437 1340392 PO Box 1169 INSURER C: Pikeville KY 41502 0�°� 0 ,% INSURER D: INSURER E: INSURER F: COVERAGES RHIRE CERTIFICATE NUMBER: 11318132 REVISION NUMBER: XXXXXXX 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP R (MM/D (MWDDrffM LIMITS • X COMMERCIAL GENERAL LIABILITY N N 36043255 6/1/2019 6/1/2020 EACH OCCURRENCE 2,000,000 CLAIMS-MADE OCCUR PREMISETOR EoNccTErence2,000,000 MED EXP(Any oneperson) 10 000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY❑JECT FX LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER, $ A AUTOMOBILE LIABILITY N N 73609308 6/1/2019 6/1/2020 COMBINED SINGLE LIMIT Ea accident $ 2,000,000 X ANY AUTO BODILY INJURY(Per person) $ XXX)�X}� AUTOS ONLY SCHEDULED BODILY INJURY(Per accident $ XXXXXXX AUTOS ONLY NON-OWNED ONLDY PeoacEaCenDAMAGE $ ��XX $ XXXXXXX B X UMBRELLA LIAB X OCCUR N N 013136615 6/1/2019 6/1/2020 EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 51000,000 DED I I RETENTION$ Prod.Comp.Ops $ 5,000,000 WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N NOT APPLICABLE STATUTE ER ANY PROPRIMBERIPARTNDED? CUTNE ❑ N/A E L EACH ACCIDENT $ XXXXXXX OFFICERIMEMBER EXCLUDED? (M ya en datory In NFQ E L DISEASE-EA EMPLOYEE XXXXXXX If DESCRIPTION OF be rPERATIONS below E L DISEASE-POLICY LIMIT I XXXX�7� 11�X DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached H more space Is required) NAMED INSURED INCLUDES MCCLANE CANYON MINING,LLC.MCCLANE CANYON MINE,PERMIT NO.C-1981-004 CERTIFICATE HOLDER CANCELLATION See Attachment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 11318132 AUTHORIZED REPRESENTATIVE DIVISION OF RECLAMATION MINING&SAFETY 1313 SHERMAN ST. ROOM#215 DENVER, CO 80203 ACORD 25(2016/03) 01988- CORD CO ORA N.All rights reserved The ACORD name and logo are registered marks of ACORD