2022-06-01_GENERAL DOCUMENTS - C1981022

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DATE(MM/DD/YYYY) A�ORO CERTIFICATE OF LIABILITY INSURANCE I 05/23/2022 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT y NAME: Aon Risk Services Southwest, Inc. 2 FAX -0105( C . C866) 283-712 B00) 363 Dallas TX Office NoExt): A/C No.): �- 5005 Lyndon B Johnson Freeway E-MAIL 6 suite 1500 ADDRESS: _ Dallas TX 75244 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Zurich American Ins CO 16535 Oxbow Energy Solutions LLC INSURERB: American Guarantee & Liability Ins Co 26247 1601 Forum Place suite 1400 INSURERC: west Palm Beach FL 33401-8101 USA INSURERD: INSURER E: INSURER F: ';t1� COVERAGES CERTIFICATE NUMBER: 570093186856 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 W IS POLICY NUMBER MM/DD/POLICY F-F MM/DD/YYY LIMITS X COMMERCIAL GENERAL LIABILITY GILD EACH OCCURRENCE $2,000,000 General Liablity CLAIMS-MADE ❑X OCCUR - S1,000,OOO SIR applies per policy terns & conditions PREMISES Ea occurrence _ MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 L GEML AGGREGATE LIMIT APPLIES PER. GENERALAGGREGATE $4,000,005 2 POLICY ❑JE ❑X LOC PRODUCTS-COMP/OP AGG $2,000,000 0 OTHER. o n A AUTOMOBILE LIABILITY BAP 9265950-12 06/01/2022 06/01/2023 COMBINED SINGLE LIMIT $1,000,000 � Eaccident) „ AINY AUTO BODILY INJURY(Per person) Z OWNED SCHEDULED BODILY INJURY(Per accident) ,4) AUTOS ONLY AUTOS H RED AUTOS NON-OWNED PROPERTY DAMAGE V X Per accident := ONLYI AUTOS ONLY X �y B X UMBRELLA LIAB x OCCUR AUC926593712 06 01 2022 6 01/2 23 EACH OCCURRENCE $15,000,000 d EXCESS LIAB CLAIMS-MADE umbrella AGGREGATE $15,000,000 DED I X RETENTION$10,000 WORKERS COMPENSATION AND PER STATUTE I OTH- EMPLOYERS'LIABILITY Y/N ER ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE 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) RECEIVED JUN 0 2 2022 � CERTIFICATE HOLDER CANCELLATION 8 ��N ��y SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE `UMI SA c�� EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Division Of Minerals & Geology AUTHORIZED REPRESENTATIVE j Attn: Bill Carter �f� �Q �i b Room Shermam street c '6�G.tlYE yiDtrR,ae1�eJ�e-. L Room 215 Denver CA 80203 USA 01988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD