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DATE(MM/DD/YYYY) <br /> A�/?0 CERTIFICATE OF LIABILITY INSURANCE I <br /> 05/23/2022 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.If <br /> SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this <br /> certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT y <br /> Aon Risk Services Southwest, Inc. NAME. FAX <br /> Dallas TX Office (A/C.No.Ext): (866) 283-7122 A/C.No.: (800) 363-0105 <br /> 5005 Lyndon B Johnson Freeway E-MAIL 2 <br /> Suite 1500 ADDRESS: <br /> Dallas TX 75244 USA <br /> INSURERS)AFFORDING COVERAGE NAIC# <br /> INSURED INSURER A: Zurich American Ins Co 16535 <br /> Oxbow Energy Solutions LLC INSURER B: American Guarantee & Liability Ins Co 26247 <br /> 1601 Forum Place <br /> Suite 1400 INSURERC: <br /> west Palm Beach FL 3 3 401-8101 USA INSURERD: <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 570093186851 REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested <br /> LTR INSIR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MWDD/YYYY LIMITS <br /> X COMMERCIAL GENERAL LIABILITY GLO EACH OCCURRENCE $2,000,000 <br /> General Liablity <br /> CLAIMS-MADE OCCUR SIR applies per policy terns & conditions PREMISES Ea occurrence $1,000,000 <br /> MED EXP(Any one person) $10,000 <br /> PERSONAL&ADV INJURY $1,000,000 <br /> GEN'LAGGREGATELIMITAPPLIESPER. GENERAL AGGREGATE $4,000,000 ro <br /> POLICY ❑PRO- ❑X LOC PRODUCTS-COMP/OPAGG $2,000,000 rn <br /> 0 <br /> OTHER o <br /> n <br /> A AUTOMOBILE LIABILITY BAP 9265950-12 06/01/2022 06/01/2023 COMBI tlED SINGLE LIMIT $1,000,000 un, <br /> Ea accent) <br /> BODILY INJURY(Per person) C <br /> x ANY AUTO Z <br /> OWNED SCHEDULED BODILY INJURY(Per accident) C! <br /> AUTOS ONLY AUTOS W <br /> x HIREDAUTOS NON-OWNED PROPERTYDAMAGE V <br /> ONLY AUTOS ONLY Per accident <br /> t <br /> tY <br /> B X UMBRELLA LIAB X OCCUR AUC926593712 06 O1 2022 06 01 2023 EACH OCCURRENCE 15,000,000 V <br /> umbrella AGGREGATE $15,000,000 <br /> EXCESS LIAB CLAIMS-MADE <br /> DED I X RETENTION SID,000 <br /> WORKERS COMPENSATION AND PER STATUTE OTH• <br /> EMPLOYERS'LIABILITY Y/N ER <br /> ANY PROPRIETOR/PARTNER,EXECUTIVE E L.EACH ACCIDENT <br /> OFFICER/MEMBER EXCLUDED' ❑ N/A <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE <br /> If as,describe under <br /> DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT <br /> i' <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) �••� <br /> See Attachment: <br /> RE: Terror Creek Company. C-1983-059 RECEIVED <br /> Ps <br /> dUN <br /> CERTIFICATE HOLDER ELLATION <br /> S <br /> DIVISION M RE SHOULD ANY OF THE ABOVE DATE THEREOF, NOTICE WILL BE DEICIES BE LIVERED IN CANCELLEDA ACCORDANCE WITH THE cc <br /> ININGV�11\„D 1A VISIONS. <br /> Division of Minerals & Geology AUTHORIZED REPRESENTATIVE <br /> 1313 Sherman street <br /> Room 215 c c3 r�sGt4fc�tld c/c�d� es g <br /> Denver CO 80203 USA <br /> 8 <br /> 01988-2015 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />