2022-06-01_GENERAL DOCUMENTS - C1983059

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ACORO� DAT 05/3 20 2YYY) CERTIFICATE OF LIABILITY INSURANCE 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 4! Aon Risk Services Southwest, Inc. PHONENAME. FAX L Dallas TX Office (A/C.No.Ext): (866) 283-7122 AC.No.: C800) 363-0105 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 INSURERB: American Guarantee & Liability Ins Co 26247 1601 Forum Place Suite 1400 INSURERC: West Palm Beach FL 3 3 401-8101 USA INSURERD: INSURER E: INSURER F: , COVERAGES CERTIFICATE NUMBER:570093186861 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 INSH LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY GLO EACH OCCURRENCE $2,000,000 General Liablity DAMAGE TO RFNTE CLAIMS-MADE ❑X OCCUR SIR applies per policy ter s & condi ions PREMISES Ea occurrence $1,000,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 ip GEN'LAGGREGATELIMITAPPLIESPER GENERAL AGGREGATE $4,000,00000 POLICY ❑PRO- JECT �X LOC PRODUCTS•COMP/OP AGG $2,000,000 0 OTHER n A AUTOMOBILE LIABILITY BAP 9265950-12 06/01/2022 06/01/2023 COMBINED SINGLE LIMIT $1,000,000 LO (Ea accident) X ANY AUTO BODILY INJURY(Per person) Z OWNED SCHEDULED BODILY INJURY(Per accident) r0 AUTOS ONLY AUTOS PROPERTY DAMAGE cc X HIRED AUTOS NON-OWNED V ONLY AUTOS ONLY Per accident N B X UMBRELLA LIAB X OCCUR AUC926593712 0675712022 06 01 2023 EACH OCCURRENCE $15,000,000 rJ EXCESS LIAB CLAIMS-MADE umbrella AGGREGATE $15,000,000 DED I X IFIETENTION$10,000 77 WORKERS COMPENSATION AND PER STATUTE OTH- EMPLOYERS'LIABILITY Y ER ANY PROPRIETOR/PARTNER/EXECUTIVE /N❑ E L.EACH ACCIDENT OFFICER/MEMBER EXCLUDE09 N/A (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) CERTIFICATE HOLDER CANCELLATION 8 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Co DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE ,p POLICY PROVISIONS. 2552 Division of Minerals & Geology AUTHORIZED REPRESENTATIVE o Attn: Bill Carter o 1313 Sherman Street Room `J x Room 215 8 Denver Co 80203 USA / 8 01988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD