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® <br />CERTIFICATE OF LIABILITY INSURANCE <br />A ° 06/(2 0 0 <br />page 1 of 2 <br />PRODUCER 877-945-7378 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Willis of Tennessee, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />26 Century Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />P. O. Box 305191 <br />Nashville, TN 37230-5191 INSURERS AFFORDING COVERAGE NAIC# <br />INSURED Basin Resources, Inc. INSURERA:Zurich American Insurance Company 16535-000 <br />Attn: Tom Durham INSURER B: <br />2 North Cascade Ave. <br />2nd Floor INSURERC: <br />Colorado Spring, CO 80903 INSURER D: <br /> INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE <br />DATE (MWDDIYYYY) POLICY EXPIRATION <br />DATE M DD <br /> <br />LIMITS <br />A GENERAL LIABILITY GLO654147901 7/1/2010 7/1/2011 EACHOCCURRENCE $ 1,000,000 <br /> X COMMERCIAL GENERAL LIABILITY PREMISES Eaoccurence $ 1,000,000 <br /> CLAIMS MADE OCCUR ?7ry7 MED EXP (Any one person) $ 10,000 <br /> rm PERSONAL& ADV INJURY $ 1,000,000 <br /> (??O GENERAL AGGREGATE $ 2,000,000 <br /> <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />[['?i n <br />Jb' <br />l4j <br />PRODUCTS -COMP/OPAGG <br />$ 2,000,000 <br /> 1 7 POLICY " <br /> <br />0- 1-1 LOC <br />JECT <br /> <br /> AUT OMOBILE LIABILITY waiving <br />COMBINED SINGLE LIMIT <br /> <br />ANY AUTO <br />(Ea accident) $ <br /> ALL OWNED AUTOS BODILY INJURY <br /> SCHEDULEDAUTOS (Per person) $ <br /> HIRED AUTOS <br />BODILY INJURY <br /> <br />NON-OWNED AUTOS <br />(Per accident) $ <br /> PROPERTYDAMAGE <br /> <br />id <br />P $ <br /> ent) <br />( <br />er acc <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EA ACC $ <br /> AUTOONLY: AGG $ <br /> EXCESS/UMBRELLA LIABILITY EACHOCCURRENCE $ <br /> <br /> OCCUR EICLAIMS MADE AGGREGATE $ <br /> <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION WCSTATU- OTH- <br />T OC <br /> ' R LIMIT ER <br /> AND EMPLOYERS <br />LIABILITY Y/N <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE ? - - - - - -EL. EACH ACCIDENT <br />$ <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ <br /> If yes, describe under <br /> SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ <br /> OTHER <br />DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS <br />RE: The Golden Eagle Mine - Permit #C-81-013 <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />State of Colorado IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />Attn: Joseph Dudash <br />Mined Land Reclamation Office REPRESENTATIVES. <br />1313 Sherman Street, Room 215 AUTHORIZED REPRESENTATIVE <br />Denver, CO 80203 <br />ACORD 25 (2009/01) Coll:3055885 Tpl:1107231 Cert:14350354 ©1988-2009ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD