2023-06-06_GENERAL DOCUMENTS - C1981022

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DATE05 3/2023YYY) t✓ 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 CONTACTp Aon Risk Services Southwest, Inc. NAME: Dallas TX Office (AC.No.Ext): (866) 283-7122 (AC No.): (800) 363-0105 5005 Lyndon a Johnson Freeway ADDRESS: _ Suite 1500 Dallas Tx 75244 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: American Guarantee & Liability Ins CO 26247 OXBOW Energy Solutions LLC INSURERB: 1601 Forum Place Suite 1400 INSURER C: west Palm Beach FL 3 3 401-8101 USA INSURERD: INSURER E: INSURER F: , COVERAGES CERTIFICATE NUMBER: 570099642675 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/YYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY GLO EACH OCCURRENCE $2,000,000 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 GEN'LAGGREGATE LIMITAPPLIES PER GENERAL AGGREGATE $4,000,000 v POLICY ❑PRO JE ❑X LOC PRODUCTS-COMP/OP AGG $2,000,000 rn 0 OTHER. o t` A AUTOMOBILE LIABILITY BAP 9265950 13 06/01/2023 06/01/2024 COMBINED SINGLE LIMIT $1,000,000 Ea accident) _ ANY AUTO BODILY INJURY(Per person) Z OWNED SCHEDULED BODILY INJURY(Per accident) ! AUTOS ONLY AUTOS PROPERTY DAMAGE V X HIREDAUTOS NON-OWNED Per XIaccident ONLY AUTOS ONLY f: d A X UMBRELLA LIAB X OCCUR AUC 26593713 06 01 2023 06/01 2024 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 I OTH- EMPLOYERS'LIABILITY ER ANY PROPRIETOR!PARTNER/EXECUTIVE EL EACH ACCIDENT OFFICERIMEMBER EXCLUDED9 N/A - (Mandatory in NH) E.I. DISEASE-EA EMPLOYEE If yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT T 7 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: Elk and Sanborn Creed Mines, Permit# C-1981-022. Commercial General Liability Coverage includes the use of explosives. CERTIFICATE HOLDER CANCELLATION m S SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE 9 ��ryyy POLICY PROVISIONS. S Division Of Minerals & Geology AUTHORIZED REPRESENTATIVE 0 1313 Sherman street Room 215 �y Y�JL g 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