2023-06-06_GENERAL DOCUMENTS - C1983059 (2)

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DATE(MM/DD/YYYY) A�o CERTIFICATE OF LIABILITY INSURANCE 05/31/2023 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 p NAME: Aon Risk services southwest, Inc. FAX Dallas TX Office (A/C.No.Ext): (866) 283-7122 aC.No.): (800) 363-0105 5005 Lyndon B Johnson Freeway E-MAIL 2 Suite 1500 ADDRESS: 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 INSURERC: West Palm Beach FL 3 3 401-8101 USA INSURERD: INSURER E: INSURER F: , COVERAGES CERTIFICATE NUMBER: 570099642681 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 POLICY FFF POLICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY GLO EACH OCCURRENCE $2,000,000 General Liablity 'E ToCLAIMS-MADE ❑X OCCUR SIR applies per policy terns & conditions PREMISES EaOCCurrance $1,000,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE $4,000,000 POLICY F_�PRO �X LOC PRODUCTS-COMP/OP AGG $2,000,000 JE OTHER: 0 n A AUTOMOBILE LIABILITY BAP 9265950 13 06/01/2023 06/01/2024 COMBINED SINGLE LIMIT $1,000,000 LO (Ea accident) __-_- X ANYAUTO BODILY INJURY(Per person) _ 0 OWNED SCHEDULED BODILY INJURY(Per accident) 0) AUTOS ONLY P AUTOS PROPERTY DAMAGE (aNON-OWNED r accident x HIRED AUTOS V ONLY AUTOS ONLY (Pe 1r d A X UMBRELLALIAS X OCCUR AUc926593713 06 O1 2023 06/01 2024 EACH OCCURRENCE $15,000,000 V EXCESS LIAB CLAIMS-MADE umbrella AGGREGATE $15,000,000 DED I X RETENTION 410,000 WORKERS COMPENSATION AND PER STATUTE OTH- EMPLOYERS'LIABILITY ER ANY PROPRIETOR i PARTNER/EXECUTIVE Y/❑N 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 I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) FJ see Attachment: RE: Terror Creek Company. C-1983-059 CERTIFICATE HOLDER CANCELLATION O O SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE `ro POLICY PROVISIONS. $ Division Of Minerals & Geology AUTHORIZED REPRESENTATIVE 0 1313 Sherman Street S Room 215 `! x Denver CO 80203 USA 0 01988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD