2020-09-08_GENERAL DOCUMENTS - C1981035

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�1 ® A� o CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 08/26/2020 F 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 Aon Risk Services Southwest, Inc. Houston TX Office CONTACT NAME: (A/C No. Ext): (866) 283-7122 (AIC. No.): (800) 363-0105 E-MAIL ADDRESS: 5555 San Felipe Suite 1500 INSURER(S) AFFORDING COVERAGE NAIC # Houston Tx 77056 USA INSURED INSURER A: Imperium Insurance Company 35408 GCC Energy, LLC 6473 County Road 120 Hesperus Co 81326 USA SEP 0 82020 INSURER B: Rockwood Casualty Ins Co 35505 INSURER C: INSURER D: INSURER E: )VISION OF RECLAMATION Aldn gAF=TV INSURER F: COVERAGES CERTIFICATE'NUMBER: 570083721242 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 INSD WVD POLICY NUMBER POLICY EF MM/DD/YYY MM/DD/YYY LIMBS A X COMMERCIAL GENERAL LIABILITY MNGIICGL EACH OCCURRENCE $1,000,000 CLAIMS-MADEX❑ OCCUR DAMAGE TO RENTED PREMISES Ea occurrence)$100, 000 MED EXP (Any one person) $5,000 PERSONAL &ADV INJURY $1,000,000 N'LAGGREGATELIMITAPPLIESPER. GENERALAGGREGATE $2,000,000 POLICY ❑ PRO ❑ LOC JECT MX PRODUCTS - COMP/OPAGG $2,000,000 OTHER A AUTOMOBILE LIABILITY MNG-IIC-CA-0000251-00 09/01/2020 09/01/2021 COMBINED SINGLE LIMIT $1,000,000 Ea accident BODILY INJURY ( Per person) X ANYAUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED ONLY AUTOS ONLY PROPERTY DAMAGE Per accident A UMBRELLALIAB X OCCUR MNGIICCX000021100 09/01/2020 09/01/2021 EACH OCCURRENCE $10,000,000 X EXCESS LIAB CLAIMS -MADE AGGREGATE $10,000,000 DED RETENTION B WORKERS COMPENSATION AND EMPLOYERS'LIABILITYY/N ANY PROPRIETOR / PARTNER / EXECUTIVE WC694813 09/01/2020 09/01/2021 X I PER STATUTE I JOTH- ER E L EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED9 (Mandatory in NH) N / A E L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E L DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space is required) RE: OSM Permit CO -0106, CDRMS Permit CO -1981-035. Colorado Division of Reclamation, Mining & Safety is included as Additional Insured in accordance with the policy provisions of the General Liability policy. 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. Colorado Division of Reclamation, AUTHORIZED REPRESENTATIVE Mining & Safety 1313 Sherman Street, Room 215 Denver CO 80203 USA �/ JL ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD