2011-01-03_GENERAL DOCUMENTS - C1981008

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1r , 11% z' CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 12/30/2010 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 endorse m PRODUCER 12-333-3323 CONTACT NAME: Hays Companies 1 PHONE FAX A/C No Ext : A/C No): E-MAIL 80 South 8th Street ADDRESS: atD(% PRODUCER m Suite 700 CUSTOMER ID Minneapolis, MN 55402 a5af2? N?`310n0k INSURER(S) AFFORDING COVERAGE NAIC# t A INSURED +•"" T-"- `? INSURER A: LEXINGTON INS CO 19437 Western Fuels Association, Inc. INSURER B: ARCH INS CO 11150 P.O. Box 33424 INSURER C: NATIONAL UNION FIRE INS CO OF PITTS 19445 I " INSURER D Denver, CO 80233 INSURER E : Divts+? INSURER F : COVERAGES CERTIFICATE NUMBER: 19071093 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. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP MMIDDIYYYY MMlDDIYYYY LIMITS A GENERAL LIABILITY 008844193 01/01/1 01/01/12 EACHOCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TORENTED PREMISES Ea occurrence 100,000 $ CLAIMS-MADE 1XI OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OPAGG $ 2,000,000 POLICY PRO LOC Employee Benefits $ 1,000,000 B AUT OMOBILE LIABILITY CAB 0032921 02 01/01/1 01/01/12 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS (Per accident) $ X NON-OWNED AUTOS $ C UMBRELLA LIAB X OCCUR BE 21446419 01/01/1 01/01/12 EACH OCCURRENCE $ 25,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 25,000,000 DEDUCTIBLE $ X RETENTION $ 50,000 $ WORKERS COMPENSATION WC STATU- OTH- TORY LIMITS R AND EMPLOYERS' LIABILITY Y/N NY"PROPRIETOft/FARTNERlEXECUTiVE" O F F I C E R / M E M B E R EXCLUDED? (Mandatory in NH) N I A E.L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Evidence of Insurance as respects New Horizon Mine in Nucla, CO (Permit #C-81-008). Includes use of Explosives CERTIFICATE HOLDER CANCELLATION Colorado Mined Land Reclamation Mined Land Division SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1313 Sherman Street, RM 215 Denver, CO 80203 USA I AUTHORIZED REPRESENTATIVE jhargrove © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD 19071093