2010-12-06_GENERAL DOCUMENTS - C1981020

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AGORd CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/01/2010 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 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 lz) ° CONTACT NAME: Aon Risk insurance services West, Inc. 7111 Fresno CA Office c+! j (A/C.No.Ext): (559) 449-7200 (AIC.No.I: (559) 439-0863 5260 North Palm Avenue 'TE MAIL ADDRESS: Suite 400 Fresno CA 93704 USA PRODUCER 570000031836 USToMERID#: INSURER(S) AFFORDING COVERAGE NAIC # INSURED t- INSURER A: National Union Fire Ins CO Of Pittsburgh 19445 CAM Mining LLC dba central INSURER B: LLC a alachia Minin A g pp P.O. Box 1169 ?J? INSURER C: Pikeville KY 41502 USA Q INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570040931420 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 INSURAN CE 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. Limits shown are as requested INSR LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/DDIYYYY MM/DDIYYYY LIMBS GENERAL LIABILITY GL0936045 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $1,000,000 CLAIMS-MADE ? OCCUR MED EXP (Anyone person) $10,000 PERSONAL a ADV INJURY $1,000,000 C N c GENERAL AGGREGATE $2 000 000 , , co GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $2 , 000, 000 a 17 POLICY jR? X LOC o A AUTOMOBILE LIABILITY CA0935830 12/01/Z010 Ub/UI/ZUiZ COMBINED SINGLE LIMIT S1 000 000 Ea accident , , X ANY AUTO BODILY INJURY (Per person) O Z ALL OWNED AUTOS BODILY INJURY (Per accident) y SCHEDULED AUTOS PROPERTY DAMAGE V X Per accident HIRED AUTOS X NON OWNED AUTOS d U UMBRELLA LIAR OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE DEDUCTIBLE RETENTION WO RKERS COMPENSATION AND --g, _ }T- °^-'- -"-- -" EMPLOYERS' LIABILITY Y I N TORY LIMITS ANY PROPRIETOR / PARTNER I EXECUTIVE ? RIMEMBER EXCLUDED'? C N I A E.L. EACH ACCIDENT OFFI E (Mandatory in NH) E.L. DISEASE-EA EMPLOYEE - If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE-POLICY LIMIT ?r OF OPERATIONS I LOCATIONS I VEHICLES h ACORD 101 Additi A l R k S h d l if ( ttac , DESCRIPTION ona emar s c e u e, more space is required) RE: Munger Canyon Permit #C-1981-020 CERTIFICATE HOLDER CANCELLATION L SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE , EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Division of Reclamation AUTHORIZED REPRESENTATIVE Mining and safety 1313 Sherman St., Room 215 Denver CO 80203 USA Denver t?(Yo/ UFO 6{J'1? n n4tctan? Gt?vxr,0 I? ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD