2010-12-06_GENERAL DOCUMENTS - C1980004

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A? ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) t?r3anota ATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS THIS CERTIFIC 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 CONTACT NAME: Aon Risk Insurance Services West, inc. PHONE (559) 449-7200 F'O'X (559) 439-0863 No.): (A IC. No. Ext): C. Fresno CA office 5260 North Palm Avenue E-MAIL .?? Suite 400 CA 93704 USA PRODUCER 570000031836 CUSTOMER ID #: Fresno VERAGE NAIC # INSURER(S) AFFORDING CO ED INSURER A: National Union Fire Ins Co of Pittsburgh 19445 INSUR (??0?' • mccl ane Canyon Mining LLC low INSURER B: `, P.O. BOX 1169 v?, -{ l Y 41502 USA ill INSURER C: e K Pikev ? J \) ?y. ` .r`? INSURER D: INSURER E: _ INSURER F: d I? c m a_ m a 0 COVERAGES CERTIFICATE NUMBER: 570040920200 Kt=Vw1Un rvUlno0tc: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS NOTWITHSTANDING ANY REQUIREMENT ATED , . INDIC THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, TE MAY BE ISSUED OR MAY PERTAIN , CERTIFICA EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested ISR L TYPE OF INSURANCE ADD INSR UBR WVD POLICY NUMBER POLI F MMIDD POLICY E MM/D LIMIT S TR A LIABILITY (31-09315045 0 EACH OCCURRENCE $1,000,000 GEN ERAL DAMAGE-TO RENTED $1,000,000 X COMMERCIAL GENERAL LIABILITY nce PREMISES Ea occurre CLAIMS-MADE _' OCCUR MED EXP (Any one person) $10,000 PERSONAL BADVINJURY $1,000,000 00 04 GENERAL AGGREGATE 000 $2 000 N , , CO COMP/OP AGG 000 000 $2 I S PER ' PRODUCTS - , , : E L AGGREGATE LIMIT APPL GEN o POLICY PRO- X LOC o t• CA0935830 12/01/2010 06/01/2012 COMBINED SINGLE LIMIT 000 000 $1 A AUT OMOBILE LIABILITY Ea accident , , . X ANY AUTO BODILY INJURY (Per person) O Z ALL OWNED AUTOS BODILY INJURY (Per accident) y SCHEDULED AUTOS PROPERTY DAMAGE M V Per accident 4. X HIRED AUTOS X NON OWNED AUTOS U UMBRELLA LIAB OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE EXCESS LIAB EDUCTIBLE D RETENTION - ----'- _ WORKERS-COMPENSATIOWAND-- TWOCRY LIMITS ER TORY LIMITS EMPLOYERS' LIABILITY YIN L. EACH ACCIDENT E ANY PROPRIETOR / PARTNER / EXECUTIVE . OFFICER/MEMBER EXCLUDE DI ? (Mandatory In NH) N / A E.L. DISEASE-EA EMPLOYEE If yes, describe under E.L. DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS below I L i I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) MCClane Canyon Mine, Permit No. C-1981-004 CERTIFICATE HOLDER CANCELLATION r 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 and safety Minin - g 1313 Sherman St., Room 215 // Denver CO 80203 USA Denver J 10 9.14" Q[Gd?mw t% ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 26 (2009/09) The ACORD name and logo are registered marks of ACORD