2010-12-06_GENERAL DOCUMENTS - C2008086

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0YYY) CERTIFICATE OF LIABILITY INSURANCE DATEF(7MW0 11 01 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 w certificate holder in lieu of such endorsement(s). PRODUCER CONTACT d 17 AOn Risk insurance services west, Inc. NAME: PHONE Fresno CA Office _ (A/C. No. Ext): (559) 449-7200 ( FAX No ): (559) 439-0863 m 5260 North Palm Avenue a Suite 400 E-MAIL O Fresno CA 93704 USA CUSNO.UC TOMER ID #: 570000031836 = kc, INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: National Union Fire Ins Co of Pittsburgh 19445 CAM-Colorado LLC P.O. BOX 1169 !? •? j yia?"" INSURER 8: Pikeville KY 41502 USA V1 L, INSURER C: V Vt,;Y t? INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570040862828 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 INSURANCE 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 IN SR TYPE OF INSURANCE ADD UB POLICY F POLICY EXP LTR INSR WVD POLICY NUMBER MM/DD MM/DD LIMITS A GENERAL LIABILITY GLO 45 U1 2 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $1,000,000 PREMISES Ea occurrence) CLAIMS-MADE ?X OCCUR MED EXP (Any one person) $10,000 PERSONAL &ADV INJURY $1,000,000 N GENERAL AGGREGATE $2,000,000 ZN7 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- PRODUCTS - COMP/OP AGG $2,000,000 0 V POLICY F x] JECT 0 AU TOMOBILE LIABILITY CA0935830 12/01 2010 06/01/2012 COMBINED SINGLE LIMIT X Ea accident $1,000,000 ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per person) p BODILY INJURY (Per accident) Z SCHEDULED AUTOS PROPERTY DAMAGE R X HIREDAUTOS Per accident V w X NON OWNED AUTOS U UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE DEDUCTIBLE RETENTION QRKERS.GOMP NAND EMPLOYERS' LIABILITY ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA E.L. EACH ACCIDENT E.L. DISEASE-EA EMPLOYEE E.L. DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Red Cliff Mine State of Colorado, Division of Reclamation mining & Safety is included as Additional Insured. Except 10 days notice for non-payment of premium. CERTIFICATE HOLDER state of Colorado Division of Reclamation Mining & Safety 1313 Sherman St. Rm #215 Denver CO 80203 USA CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED (_RREEEPPRESEN?TAA{T-IVE /y'? "em a %G?1?cJ?lAlGtll r?Gtitod X fxa ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD