2020-08-13_GENERAL DOCUMENTS - C1981019 (2)

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ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 08/05/2020 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 right ;they certificate, holder in lieu of such endorsement(s). PRODUCER CONTACT Lacey Skalicky NAME: Hays Companies Inc. PHONE o Ext): (515) 802-3005 AlC No): (515) 802-3032 Ruan Center, 666 Grand Avenue AUG E-MAIL Iskalicky@hayscompanies.com ADDRESS: 17th Floor INSURER(S) AFFORDING COVERAGE NAIC # Des Moines DIVISION C 1,C'50309 INSURERA: Imperium Insurance Company 35408 INSURED MININ,- INSURER B Elk Ridge Mining and Reclamation LLC INSURER C: 1100 West 116th Avenue INSURER D: INSURER E: MED EXP (Any one person) $ 5,000 Westminster CO 80234 INSURER F: COVERAGES CERTIFICATE NUMBER: 2020-2021 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. NOTAIT; (STANDING ANYREQUIREMENT 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 LTR I TYPE OF INSURANCE AUULSUbll (NSD WVD POLICY NUMBER POLICY EXP MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE 1 OCCUR 7MIDD PREMISES Ea occurrence $100,000 MED EXP (Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 A MNG-IIC-GL-000347-00 08/01/2021 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO ❑ LOC JECT PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY (Per person) $ ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 X AGGREGATE $ 10,000,000 A EXCESS LIAB CLAIMS -MADE MNG-IIC-CX_0000190-00 08/01/2020 08/01/2021 [DEDX RETENTION $ UL $1 M $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY YIN STATUTE ER E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / 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 Colorado Mined Land Reclamation Mined Land Division 1313 Sherman Street, RM 215 Denver CO 80203 L;ANI:tLL.A I LUN 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