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~ ACORD,,, CERTIFICATE OF LIABILITY INSURANCE I DATE(NAVDINYYY7 <br />I 1 Q+28f05 <br />PLoft Risk Services Inc. of Florida <br />222 Lakeview Avenuc, Suite fi10 <br />West Palm Beach, FL 33401 <br />INSURED INEURERA~ I'9p9rai mSUrance tiom~any <br />Qxbow Mining LLC IN'811RERD Ha~r~F~re-fnsuranoe ompany - <br />1607 Forum Place - - <br />West Palm beach, FL 33401 ~ INSBRERC. <br />IN541RER D: . <br />I INSURERE: <br />COVERAGES <br />THE PDl ICrES CF INSURANCE L19TED 8EL0'A' HAVE BE N ISSUED TO TFE IN9iJRC O NAMED ABOV= fOR THE POLICY PERIOD INDICATED. NOTWI'I HS IANDIN <br />ANY REQUIREMENT, TCRPA OR CONDITION OF ANY CONTRACT DR OTHER DOCUMENT WI I H RESPECT 7O N'HICH THIS CERTIFICA7R MAY BE ISSUED O <br />MAY PERTAIN, THE INSURANCE AFrONUED BY THE POLICIES DESCRIBED HEREIN 19 5119.1 EC7 TD ALL THE TERMS. EXCLU9IOMS AND CONDITIONS OF SVC <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUC ED BY PAIDCLA!M$, <br />INSP DP' PDUCY NUxDER POLICY FIFE N POLICYEYPIMAOM LIMBS <br />R GENERALYABILIN <br />1 F15CH000L'RREACF <br />- <br />- f + + <br /> 3710-77-65 911!05 911 <br />06 D,arac <br />Ta~E TE <br />o <br /> CONMERC4LL G6NF3N_IIAEIUTV <br />• PREUISF6fEaes•,n,ve) S ' <br /> ~ <br />® <br /> CLAIMS MADE <br />- <br />OLCUH 6t0E%PiArcy nnPPernJ(1 , <br />-S <br /> _ PER9'JN4LahLVINJURY ~ <br />5 IrvUVlur <br /> GENERALACGREtgTE I rr <br />S <br /> _ <br />GEN'L AQ.eREGATE UMI7 AFPL16S PER: <br />~ ~ <br />~ <br />PNUWGTS-COMPIOPAGG <br />- - <br />~TT <br />5 Lryyy,>/L <br /> PCLry•Y PRU LDC <br />B ""'~''OR1LE1`""'°7Y 20UENZQ6230 91110.5 911106 DDMEINEDSINGIEDNIT , 1 <br />0OO,Oi <br />ANY AUTJ <br />^ [ERac:JCenq , <br /> _ AILOWNEOAUiOS <br />' 6WIlYINJURY <br /> SCHEOUIm NJTOS INrPtreonJ I S <br /> HIREOAUTOS <br />, I <br />9ODILY INJURY <br />S <br /> NON~O.VNEDAUTOe ~ (Poraccl]tr,B <br /> - PROPERTYDAMnGE <br /> <br />P , <br /> ( <br />dl ADC1JDIQ <br /> ' GAIIADe LiABILRY AVIVUNLY-Fa ACCIDENT E <br /> RNYALI'V DTHERTHAN EAALC f <br /> <br />AU700IJLY: ~,~ .- <br />; <br /> ERCESTJUNBREUfILIAPILRY EAQIDCCU.ikF,NCE 5 <br /> <br /> OCCUR ~ CLAIMS ALADE .AGGREGATE 5 <br /> - 5 <br /> OEDUL7ISLE __ , <br /> REfENTIDN 5 , <br /> WORNERSCONI'ENTAAONAMD WCSTATU. OTH- <br />.Ci[YLIMIT$ -_ <br /> ENPLVYERB' LIADILfTY <br /> <br />ANY?RCF'i1=TOR1PRRf1~RfEX'..~',UTI'lE E. L. EAQ-I AUGIDEHT <br />~ ~- <br /> OFF'CET4MENEERJ(CLDDFDT EA. DIpEAEt-EA ERPLOYEF $ <br /> IIYn+,dnwitc un0cr "- <br /> 9PEC4LLPRUl'I£:ONRDgPW EL. uItltR>iE-POLICY LNIR S <br /> DIRER <br />OESCRIPADR OFDPEPATIONS 7 LOCATIONS! VFNICLFS f E.YCWS10N6ADDEOBYENOORSENENTl SPECIAL PROYI90NB <br />Re: Elk Creek Mine, Permit #C1981-022 <br /> E 71E EIIPIRATIC <br />SHOULD ANYOP TIl ABOVE DESCflIHEO POLICES DE CANCELLED EEF~ <br />division of Minerals & Geology ~ <br />DATE THE11ED1, THE ISSUING INSURER WILL MAI4 „` <br />1313 Sherman Street, Room 215 wY9 WR77lNNOTILETVTHECERfLF1CATEHDLOERNAMEDTOTHELEFT- <br />Denver, CO 80203 i <br />Risk Services,Inc.M FL <br />RA Arrlon rnonnn •r,nu w n, <br />