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__•-", ® DATE(MM/DD YYYY)
<br /> A�o CERTIFICATE OF LIABILITY INSURANCE 05/27/2025
<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 i
<br /> SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this :,°�—I—I
<br /> certificate does not confer rights to the certificate holder in lieu of such endorsement(s). c
<br /> PRODUCER CONTACT -0
<br /> Aon Risk Services Southwest, Inc. PHONE FAX L
<br /> Dallas TX Office (A/C.No.Ext): (866) 283-7122 (A/C.No.): (800) 363-0105 v
<br /> 5005 Lyndon B Johnson Freeway E-MAIL c
<br /> Suite 1500 ADDRESS: _
<br /> Dallas TX 75244 USA
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURED INSURERA: American Guarantee & Liability Ins Co 26247
<br /> oxbow Mining, LLC INSURERB: Zurich American Ins Co 16535
<br /> 1601 Forum Place
<br /> Suite 1400 INSURER C:
<br /> West Palm Beach FL 3 3 401-8101 USA INSURER D:
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:570112757749 REVISION NUMBER: �47.1
<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 /> * *
<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 /> INSR ADDL-SUBR POLICY bFF POLICY EXP
<br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY ((MM/DD/YYVY� LIMITS _
<br /> 13 X COMMERCIAL GENERALLLLIABILITY GL0926594915 06/01/2025 06/O1/2626 EACH OCCURRENCE $2,000,000
<br /> CLAIMS-MADE I X IOCCUR SIR applies per policy terns & conditions DAMAGE TO RENTED $1,000,000
<br /> 111 PREMISES(Ea occurrence)
<br /> MED EXP(Any one person) $10,000
<br /> PERSONAL&ADV INJURY $1,000,000 v
<br /> GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $4,000,000
<br /> to
<br /> POLICY PRO- X LOC PRODUCTS-COMP/OPAGG $2,000,000 N
<br /> OTHER. E)
<br /> B AUTOMOBILE LIABILITY BAP 9265950 15 06/01/2025 06/01/2026 COMBINED SINGLE LIMIT $1,000,000
<br /> (Ea accident) ,
<br /> 0
<br /> BODILY INJURY(Per person)
<br /> X ANY AUTO Z
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) w
<br /> —AUTOS ONLY AUTOS 0X HIRED AUTOS NON-OWNED PROPERTY DAMAGE V
<br /> ONLY AUTOS ONLY (Per accident) o.
<br /> t
<br /> C!
<br /> A X UMBRELLALIAB X OCCUR AUC926593715 06/01/2025 06/01/2026 EACH OCCURRENCE $15,000,000 V
<br /> EXCESS LIAR CLAIMS-MADE AGGREGATE $15,000,000
<br /> DED X RETENTION$10,000
<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 /> It yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT
<br /> MI
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> RE: Permit number C - 1983-059 Terror Creek Loadout
<br /> Division of Reclamation, Mining and safety is included as Additional insured as required by written contract, but limited to M
<br /> the operations of the Insured under said contract, per the applicable endorsement with respect to the General Liability,
<br /> Automobile Liability, and umbrella Liability policies.
<br /> ei
<br /> CERTIFICATE HOLDER CANCELLATION A
<br /> ill 0
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ��..,,�� N
<br /> EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
<br /> POLICY PROVISIONS. 8
<br /> ',,�_ g Division of Reclamation, Mining AUTHORIZED REPRESENTATIVE
<br /> ilkilt and Safety S
<br /> Sherman Street, Room 215 "�-x _� Ye t ��#^
<br /> Denver CO 80203 USA tSZA 7(�._��
<br /> ©1988-2015 ACORD CORPORATION.All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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