2010-12-07_GENERAL DOCUMENTS - C1992080

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.4C - CERTIFICATE OF LIABILITY INSURANCE ? D /DDIYWII ' /3/20 123 20 10 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 BELOK 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 NCONTACT AME: Shawn BlaC O Allred-Thompson-Mason-Daugherty Ins. PAX a N o 0- 23-077 No:94 - 6 -528 Division of Higginbotham Agency -MAIL 1300 Tenth Street ADDREss:apmorgan@higginbotham.net Wichita Falls TX 76301 INSURERS AFFORDING COVERAGE NAIC# INSURER A: -C tinent Insurance C a INSURED OAKRII INSURERB:Texas Mutual Insurance Com an Oakridge Energy Inc INSURER C: 4613 Ja.cksboro Hwy INSURER D: Wichita. Falls TX 76302 INSURER E : INSURER F : UUVtKA(iEJ ULKI11-IUAtrz NUMBER: SGaaGZoGa 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. ILTRR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/LDD EFF W ICY EXP LIMITS GENERAL LIABILITY 04GL000807841 2/5/2010 2/5/2011 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence) _$_100,000 CLAIMS-MADE FIOCCUR MED EXP (Any one person) $Excluded PERSONAL BADVINJURY $1,000,000 _ GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $2,000,000 E'T POLICY PRO- X LOC $ AUT OMOBILE LIABILITY 04CA002780714 2/5/2010 2/5/2011 COM Ea accident $1,000,000 X ANYAUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS F NON-OWNED AUTOS PROPERTY DAMAGE Per accident $ UMBRELLALIAB OCCUR 04XS169486 2/5/2010 2/5/2011 EACH OCCURRENCE $1000000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $1000000 LIED X RETENTION $10000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY BP0001027321 /14/2010 /19/2011 WC STATtf- OTH- O LI TS R YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ? OFFICER/MEMBER EX NIA E.L. EACH ACCIDENT $1,000,000 CLUDED? (Mandatory in NH) E.L. DISEASE- EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS be E.L. DISEASE-POLICY LIMIT $1,000,000 : DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more apace is required) Carbon Junction Coal Mine, CDRMS Permit #C-92-080, Ewing Mesa, La Plata County, Colorado Certificate Holder will be given 30 day Notice of Cancellation. VCR I t rm m t r nvi-uCK UANGtLLA I IUN Colorado Division of Reclamation, Mining & Safety 1313 Sherman, Room #215 Denver CO 80203 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUMOR¢ED REPRESENTATIVE ©1988 2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010105) The ACORD name and logo are registered marks of ACORD