2022-06-01_GENERAL DOCUMENTS - C1981022

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DATE(MM/DD/YYYY) A�o 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 2D certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT "a Aon Risk Services Southwest, Inc. NAME: ` Dallas TX Office PHONE Ext): (866) 283-7122 F, No): (800) 363-0105 0O 5005 Lyndon B Johnson Freeway E-MAIL p Suite 1500 ADDRESS: _ Dallas TX 75244 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Zurich American Ins Co 16535 oxbow Energy Solutions LLC INSURER B: American Guarantee & Liability ins CO 26247 1601 Forum Place Suite 1400 INSURER C: West Palm Beach FL 3 3 401-8101 USA INSURERD: INSURER E: INSURER F• ' COVERAGES CERTIFICATE NUMBER: 570093186859 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 POLIO EXP INSD WVD POLICY NUMBER MM/OD/YYY LIMITS X COMMERCIAL GENERAL LIABILITY GLO EACH OCCURRENCE $2,OOO,OOO CLAIMS-MADE X❑OCCUR General Liablity $1,000,000 SIR applies per policy terns & conditions PREMISES Ea occurrence MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 SO GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 8 JECT POLICY ❑PRO �LOC PRODUCTS-COMP/OPAGG $2,000,000 m OTHER r. A BAP 9265950-12 06/01/2022 06/01/2023 COMBINED SINGLE LIMIT `O AUTOMOBILE LIABILITY $1,000,000 Ea accident) „ X ANYAUTO BODILY INJURY(Per person) Z OWNED SCHEDULED BODILY INJURY(Per accident) AUTOS ONLY AUTOS X HIRED AUTOS NON-OWNED PROPERTY DAMAGE ONLY AUTOS ONLY Per accident :.. t d B X UMBRELLA LIAS X OCCUR AUC926593712 06 01 2022 06 01 2 23 EACH OCCURRENCE $15,000,000 U EXCESS LIAR CLAIMS-MADE umbrella AGGREGATE $15,000,000 DED I X RETENTION$10,000 WORKERS COMPENSATION AND PER STATUTE 0TH- 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/V�CLES(ACORDi O�AdditionDal Remarks Schedule,maybe attached if more space is required) ECE � JUN 0 2 2022 CERTIFICATE HOLDER MINING141.. ,, LTY CANCELLATION 8 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Division of Minerals & Geology AUTHORIZED REPRESENTATIVE mo Attn: Bill Carter1313 g Sherman Street �1`� . Room 215 Denver 25 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