2011-02-01_GENERAL DOCUMENTS - C1980001

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ACi° '1°r CERTIFICATE OF LIABILITY INSURANCE DATE /YYYY) 01/28 //2011 2011 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(les) 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 MARSH RISK & INSURANCE SERVICES NAME: 345 CALIFORNIA STREET, SUITE 1300 PHONE FAX A/C No Ext : A/C No CALIFORNIA LICENSE NO. 0437153 E-MAIL SAN FRANCISC094104 ADDRESS: PRODUCER CUSTOMER ID 025158-001-- 007C INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A : ACE American Insurance Company 22667 CHEVRON MINING, INC. 116 INVERNESS DRIVE INSURER B : SUITE 207 INSURER C : ENGLEWOOD, CO 80112 INSURER D INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: SEA-001727016-35 REVISION NUMBER- 17 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 INS SUER POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY CMR G23743036 03/01/2011 03/01/2012 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREM SESOEa.. ence $ X ? CLAIMS-MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 _ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000 POLICY PECT E LOG $ AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULED AUTOS BODILY INJURY (Per accident) - $ PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS $ A UMBRELLA LIAB OCCUR XLX G23743061 03/01/2011 03/01/2012 EACH OCCURRENCE $ 3,500,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 6,500,000 DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION C STATU- OTH- TO AND EMPLOYERS' LIABILITY RY LIMIT R Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? [] N / A E.L. EACH ACCIDENT $ (Mandatory in NH) If d ib d E.L. DISEASE - EA EMPLOYE $ yes, escr e un er DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) This Certificate shall provide for personal injury and property damage as a result of surface coal mining and reclamation operations including arising from th use of explosI t the Insured's Edna Mine in Colorado. The issuing Company shall notify the below named Certificate Holder whenever substantive changes are made in the above described iei rfcl 'n er i or failure to r new, ithin 30 days. aOI/ . LdN /GE ?il&S//7?NT r? rv? rv?v?r? 1,ANL r_I_LAI IUIV /7(fi ZTMAWJC//NA/ fAJ51,W99%0LF_ O'AF"AWII/V Division of Reclamation, Minerals and Safety Attn: Janet Binns 1313 Sherman Street, Room 215 Denver. CO 80203-2273 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 REPRESENTATIVE of Marsh USA Inc. Wendy Sokol '?rnc?./ CI- ZrlfTC ACORD 25 (2009/09) U 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD