2022-06-01_GENERAL DOCUMENTS - C1981022

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AFRO---, ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/D022 os/za/2ozz 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). 01 PRODUCER CONTACT Aon Risk services Southwest, Inc. _159 NAME FAX i Dallas TX Office (A/C.No.Ext): (866) 283-7122 A C.No.): (800) 363-0105 5005 Lyndon 8 Johnson Freeway E-MAIL Suite 1500 ADDRESS: Dallas TX 75244 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Zurich American Ins Co 16S35 Oxbow Mining, LLC INSURER B: 1601 Forum Place Suite 1400 INSURERC: west Palm Beach FL 3 3 401-8101 USA INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570093186882 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 LTA TYPE OF INSURANCE DUL U13 POLICY NUMBER MM/0D/FULICY EF XP MMiDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY GL0 EACH OCCURRENCE $2,OOO,000 CLAIMS-MADE ❑X OCCUR SIR applies per policy terns & conditions $1,000,000 PREMISES Ea occurrence MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER. GENERAL AGGREGATE $4,000,000co POLICY ❑PRO- 7 LOC PRODUCTS•COMP/OP AGG $2,000,000 JECT OTHER, o t` A AUTOMOBILE LIABILITY BAP 9265950-12 06/01/2022 06/01/2023 COMBINED SINGLE LIMIT $1,000,000 Ea accident)ent , X ANYAUTO BODILY INJURY(Per person) 0 OWNED SCHEDULED BODILY INJURY(Per accident) 4) AUTOS ONLY AUTOS ii PROPERTY DAMAGE X HIRED AUTOS NON-OWNED Per PERT accident) ONLY AUTOS ONLY t UMBRELLALIAB HOCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE DED RETENTION WORKERS COMPENSATION AND PER STATUTE I OTH- EMPLOYERS'LIABILITY Y{N ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E L EACH ACCIDENT OFFICER/MEMBER EXCLUDED9 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE If as,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) RE: Elk Creek Mine Permit #1981 - 022 RECF1111M ']a: CERTIFICATE HOLDER JUNlM Z044 CANCELLATION AS � A SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE [" 7;T TtiVI.�'t EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE c^ POLICY PROVISIONS. Division Of Reclamation �i AUTHORIZED REPRESENTATIVE Mining and Safety 1313 Sherman Street Room �� Room 215 Denver Co 80203 USA 01988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD