2011-06-20_GENERAL DOCUMENTS - C1983059

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0 A?o,RO CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 06I06I2011 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 1S 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 i k i NAME: Aon R s ces, Inc of Florida serv N 222 Lakeview Avenue No. Ext): (866) 283-7122 (A/C. No.): (847) 953-5390 (AIC. Suite 510 E-MAIL west Palm Beach FL 33401 USA ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Zurich American ins Co 16535 oxbow carbon & Minerals, LLC INSURER B: American Guarantee & Liability Ins CO 26247 1601 Forum Place Suite 1400 INSURER C: west Palm Beach FL 33401-8101 USA INSURER D: INSURER E: INSURER F: `m >_ d a `m O 2 GUVtKAIiES GtKI1FIGAlt NUMBEK: b/UU421b1tb3 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 INSR LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMIDD/YYYY MMIDD/YYYY LIMITS A GENERAL LIABILITY GLO - EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY General Li abl i ty DAMAGE T RENTE $1,000,000 SIR applies per policy terns & conditions PREMISES Ea occurrence CLAIMS-MADE ?X OCCUR MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 oo-b GENERAL AGGREGATE $5,000,000 N GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG S2,000,000 X POLICY j E0 LOC A AUTOMOBILE LIABILITY BAP 9265950-01 Business Automobile cover X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON-OWNED AUTOS UMBRELLA LIAB OCCUR B 4DEXC ESS LIAR CLAIMS-MADE 0 ED X RETENTION $10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y / N ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? ? N / A (Mandatory in NH) -c.66eeznd^• - - DESCRIPTION OF OPERATIONS below umbrella SIR applies per policy ter s & conditions BODILY INJURY (Per person) BODILY INJURY (Per acadent) PROPERTY DAMAGE EACH OCCURRENCE AGGREGATE E.L. EACH ACCIDENT E.L. DISEASE-EA EMPLOYEE v °o $1,000,000 O Z N R U d $25,000,000 O $25,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Terror Creek LLC c-1983-059. Division of minerals & Geology is named as an Additional insured as required by written contract but limited to the operations of the insured under said contract, and always subject to the policy terms, conditions and exclusions. Commercial General Liability covers use of explosives. CERTIFICATE HOLDER 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. Division of Minerals & Geology AUTHORIZED REPRESENTATIVE -? 1313 Sherman Street Room 215 Denver CO 80203 USA ?tOfeO sErd?d ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD