2019-08-06_GENERAL DOCUMENTS - C1981019

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DATE(MM/DDYYY) A�" /YCERTIFICATE OF LIABILITY INSURANCE 08/01/2o1s 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). PRODUCER CONTACT Lacey Skalicky or Alejandra Chavez Rivas NAME: PHONEFAX Hays Companies Inc. A/c No, o Ext: (612)333-3323 A/C No): (612)373-7270 80 S 8th Street E-MAIL achavezrivas@hayscompanies com ADDRESS: Suite 700 INSURER(S)AFFORDING COVERAGE NAIC# Minneapolis MN 55402 INSURER A: Everest National Insurance Company 10120 INSURED INSURER B: ACE Property&Casualty Insurance Co 20699x Elk Ridge Mining and Reclamation LLC INSURER C: 1100 West 116th Avenue INSURER D: INSURER E: Westminster CO 80234 INSURER F: COVERAGES CERTIFICATE NUMBER: 2019-2020 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 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 ITR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDY/YYYY MM EFF POLICY DD EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO N 100,000 CLAIMS-MADE � OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ 5,000 A EN4GL00335-191 08/01/2019 08/01/2020 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER* GENERAL AGGREGATE $ 2,000,000 ❑ PRO FX LOC PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY JECT OTHER: AUTOMOBILE LIABILITY (CEO,aoc deDtSINGLE LIMIT $ ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 25,000,000 B EXCESS LIAB CLAIMS-MADE XOO G28145160 004 08/01/2019 08/01/2020 AGGREGATE $ 25,000,000 DED I X1 RETENTION $ 10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDEDI (Mandatory In NH) E L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) RECEIVED Evidence of Insurance as respects Colowyo Coal Company,L.P.(Permit#C-81019).Includes use of Explosives Y\E Cj EIVED AUG U 6 2019 DIVISION OF REC(,AiHq�� MIr ^ CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Colorado Mined Land Reclamation Mined Land Division ACCORDANCE WITH THE POLICY PROVISIONS. 1313 Sherman Street,RM 215 AUTHORIZED REPRESENTATIVE Denver CO 80203 �l @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD