2010-06-01_GENERAL DOCUMENTS - C1991078

• Permit No: C1991078
• IBM Index Class Name: GENERAL DOCUMENTS
• Doc Date: 6/1/2010
• Doc Name: Certificate of Liability Insurance
• Permit Index Doc Type: Insurance
• Email Name: MLT
• Email Name: SB1
• Media Type: D
• Archive: No

nFl TrOA-01 -SIJU
ACORO" CERTIFICATE OF LIABILITY INSURANCE 5/27/201 DATE(M/201YYY)
0
PRODUCER
First Horizon Insurance Group

3401 West End Ave. Suite 600

ie THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Nashville, TN 37203-1086
XO

' A'SURERS AFFORDING COVERAGE

NAIC #
Inc.
INSURED Delta Coals ,z ASURERA:Travelers Indemnity Company
,
Honeywood Coal Company J
,?
ru INSURER B: Travelers Indemnity of America _
95 White Bridge Road, Ste. 404 ?y INSURER c: The Travelers Ins Co
Nashville, TN 37205
INSURER D:
-..-
INSURER E:
GOVEKAGEJ
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
ANY REQUIREMENT
,
THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
MAY PERTAIN
,
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TIN -SR DD'
F
POLICY NUMBER POLICY EFFECTIVE
DATE M/DDIYYYY POLICY EXPIRATION
DATE MM/DD/YY Y LIMIT S
LTR NSR INSURANCE
-TYPE OF 000
00
1
Y EACH OCCURRENCE ,
,
$
GEN ERAL LIABILIT
A X L GENERAL LIABILITY 680-6239N556 611/2010 6/1/2011 PREMISES Ea occurence $ 300,00
COMMERCIA
MADE a OCCUR IVIED EXP (Any one person) $ 5,00
CLAIMS PERSONAL & ADV INJURY
1,000,00
$
000
00
2
GENERAL AGGREGATE '
'
$
l
d
E
d
TE LIMIT APPLIES PER:
' PRODUCTS - COMP/OP AGG e
xc
u
$
L AGGREGA
GEN
POLICY X PRO- LOG
AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00
B X A
TO BA114P571809SEL 611/2010 6/112011 (Ea accident)
ANY
U
ALL OWNED AUTOS BODILY INJURY S
EDULED AUTOS (Per person)
SCH
HIRED AUTOS BODILY INJURY $

OWNED AUTOS
NON -(Per accident)
-
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ -

TO OTHER THAN EA ACC $
ANY AU AUTO ONLY: AGG $
EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR 1 CLAIMS MADE AGGREGATE $

DEDUCTIBLE $

RETENTION $ $
X WC STATU- OTH-
WORKERS COMPENSATION ER
TORY LIMITS

C =AND_EMPLOYERS'_LIABILITY-
l ANY PROPRIETOR/PARTNER/EXECUTIV
]
7PJUB-076A6_6-6-09
6/1/2010
6/1/2011 _
E.L. EACH ACCIDENT _
$ 1000000.0
E
OFFICER/MEMBER EXCLUDED? 00
1000000
in NH)
(Mandator E.L. DISEASE - EA EMPLOYEE .
$
y
If yes, describe under
DISEASE - POLICY LIMIT
L
E 1000000.0
$
SPECIAL PROVISIONS below .
.

OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Hamilton Mine, Permit No. C-91-078
30 day Notice of Cancellation applies except for 10 day Notice of Cancellation due to non payment of premium.

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION
Colorado Division of Reclamation, DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
Mining and Safety NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
1313 Sherman Street, Room 215 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Denver, CO 80203-
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2009/01) ? 1?uw .... ......?.. - --- The ACORD name and logo are registered marks of ACORD