2025-03-11_GENERAL DOCUMENTS - C1981008

Home Browse Search

AIC ® DATE /DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 02/28/2025 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 McGriff,a Marsh&McLennan Agency LLC Company NAME: 9 Y P Y PHONE 1-800-476-2211 FAX 2000 International Park Drive RECEIVED (A/C.No.Extl• (A/C,No): Suite 600 E-MAIL Birmingham,AL 35243 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# MAR 1 17025 INSURER A:Impenum Insurance Company 35408 INSURED INSURER B:Great Midwest Insurance Company 18694 Elk Ridge Mining and Reclamation,LLC 1100 West 116th Avenue INSURER C: Westminster,CO 80234 Mining andColofado Division of Reclamation, Safety INSURER D INSURER E• INSURER F• COVERAGES CERTIFICATE NUMBER:EKFQGVDJ 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. INSRTR INSD TYPE OF INSURANCE ADDL SUER WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY MNG-IIC-GL-0000347-05 03/01/2025 03/01/2026 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE piOCCUR PREMISES(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 X POLICY ri PRO LOC PRODUCTS-COMP/OP AGG $ 2,000,000 JECT OTHER. $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT _ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY _ AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) B UMBRELLA LIAB X OCCUR MNG-GM-CX-0000281-02 03/01/2025 03/01/2026 EACH OCCURRENCE $ 5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE 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/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Evidence of insurance as respects New Horizon North Mine in Nucla,CO(Permit#C-2010-089)and New Horizon Mine(Permit#C-81-008).The policies do not contain an XCU exclusion. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Colorado Mined Land Reclamation Board Division of Reclamation AUTHORIZED REPRESENTATIVE 1313 Sherman Street,RM 215 Denver,CO 80203 Page 1 of 2 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD