2024-06-11_GENERAL DOCUMENTS - C1983059

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__----.410 ® ..44C-0120 DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 06/03/2024 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 41 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). c PRODUCER CONTACT -o NAME: AOn Risk Services Southwest, Inc. PHONE FAX t Dallas TX Office (A/C.No.Ext): (866) 283-7122 (A/C.No.): (800) 363-0105 5005 Lyndon B Johnson Freeway E-MAIL 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 33401-8101 USA INSURER D: INSURER E. INSURER F: , COVERAGES CERTIFICATE NUMBER:570106025410 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY GL0926394914 06/01/2024 06/01/2025 EACH OCCURRENCE $2,000,000 CLAIMS-MADE I X (OCCUR General Liablity DAMAGE TO RENTED SIR applies per policy terns & conditions PREMISES(Ea occurrence) $1,000,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 0 GEN'L AGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE $4,000,000 N POLICY dECOT n LOC PRODUCTS-COMP/OP AGG 52,000,000 a OTHER O A BAP 9265950 14 06/01/2024 06/01/2025 COMBINED SINGLE LIMIT in AUTOMOBILE LIABILITY $1,000,000 (Ea acadentl .. X ANY AUTO BODILY INJURY(Per person) o Z OWNED —SCHEDULED BODILY INJURY(Per accident) .d. AUTOS ONLY _ AUTOS tp X HIRED AUTOS NON-OWNED PROPERTY DAMAGE V ONLY AUTOS ONLY (Per accident) r a) B X UMBRELLA LIAB X OCCUR AuC926593714 06/01/2024 06/01/2025 EACH OCCURRENCE $15,000,000 0 Umbrella AGGREGATE $15,000,000 EXCESS LIAB CLAIMS-MADE DED X RETENTION$10,000 ' WORKERS COMPENSATION AND PER STATUTE OTH EMPLOYERS'LIABILITY y/NER ANY PROPRIETOR/PARTNER/EXECUTIVE ri 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 ' \ EE DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACO I�T81rCrremarks SDchedule,may be attached if more space is required) See Attachment: 21 0 1 1 2O24 pT10N REC1IN - RE: Terror Creek Company. C-1983-059 DIMS(t41 pr1D SAFTEY cr CERTIFICATE HOLDER CANCELLATION g s SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ovieP Division of Minerals & Geology AUTHORIZED REPRESENTATIVE V n o 1313 Sherman Street t.- 0 ROOM irls" i Denverl5 CO 80203 USA igAireYsltarzi Youli fY� ✓ iM ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD