2019-06-07_GENERAL DOCUMENTS - C2010088 (2)

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ACORL° CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DD/YYYY) 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 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). CONTACT PRODUCER Lockton Companies NAME: FAX Three City Place Drive,Suite 900 A/c Nc Et): AIC,No): St.Louis MO63141-7081E-MAIL (314)432-0500 "' ADDRESS: INSURERM AFFORDING COVERAGE NAI INSURER A: Federal Insurance Company 20281 INSURED Rhino Resource Partners,LP JUN M13 INSURER B: Lexington Insurance ComDany 19437 1340392 PO Box 1169 Pikeville KY 41502 INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES RMRE CERTIFICATE NUMBER: 11318089 REVISION NUMBER: XXXXXXXXX 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. INTSRR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLMMID DICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY Y N 36043255 6/1/2019 6/1/2020 EACH OCCURRENCE 2,000,000 CLAIMS-MADE�OCCUR DAMAGE TO NTED 2 PREMISES REEa occurrence 000000 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 X❑LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY N N 73609308 6/1/2019 6/1/2020 Ea COMBINED LIMIT $ 2,000,000 X ANY AUTO BODILY INJURY(Per person) $ XX XXXXXXXX OWNED SCHEDULED BODILY INJURY Per accident $ �� AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ �� AUTOS ONLY AUTOS ONLY Per accident $ XXXXXXXX X B X UMBRELLALIAB X OCCUR N N 013136615 6/1/2019 6/1/2020 EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED I I RETENTION$ Prod.Comp.Ops $ 5,000,000 WORKERS COMPENSATION STATUTE OER AND EMPLOYERS'LLABILITY Y/N NOT APPLICABLE ANY PROPRIETORIPARTNERIEXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ XXXXXXXXXX OFFICERIMEMBER EXCLUDED? (Myaensdatory In NH) E.L.DISEASE-EA EMPLOYEE XXXXXXXXX DESCRdMe ION OF OrPERATIONS below ,J7 ` ccam�=VVV E.L DISEASE-POLICY LIMIT 1'1��X�'1l1/111� vv DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached ff more space Is required) NAMED INSURED INCLUDES CAM-COLORADO,LLC. STATE OF COLORADO,DIVISION OF RECLAMATION MINING&SAFETY IS ADDITIONAL INSURED UNDER GENERAL LIABILITY AS REQUIRED BY WRITTEN CONTRACT.RE:UNIT TRAIN LOADOUT 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. 11318089 AUTHORIZED REPRESENTATIVE STATE OF COLORADO DIVISION OF RECLAMATION MINING&SAFETY 1313 SHERMAN ST. ROOM#215 DENVER, CO 80203 � ACORD 25(2016/03) C 1988-A*&tY%4!-OiiD—COMy-ORA�hON.All rights reserved The ACORD name and logo are registered marks of ACORD