2011-06-17_GENERAL DOCUMENTS - C1983059 (4)

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'A , CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 06/06/2011 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(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 CONTACT Aon Risk services Inc of Florid NAME: , a O 283 7 866 22 A N 222 Lakeview Avenue ) - 1 (a C. No.: (847) 953-5390 /C o. Ext): ( - ( Suite 510 E-MAIL west Palm Beach FL 33401 USA ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED -a INSURER A: Zurich American ins Co 16535 Oxbow carbon & Minerals, LLC 1601 Forum Place INSURER B: American Guarantee & Liability Ins CO 26247 suite 1400 JON N INSURER C O , West Palm Beach FL 33401-8101 USA INSURE a , R D: ?e* G J? INSURER E: I NSURER F: _WVCFXMVCJ U IMM11r Il.HY,L"IV l11Vlt5 F'K' 7/\1114//.'1//25.'1 wr viI Ir 11U NIIM F[?-N• 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 LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/DWYYYY MM/DDIYYYY LIMITS A GENERAL LIABILITY GLO - l OCCURRENCE $1,000,000 Genera Liablity DAMAGE TO X COMMERCIAL GENERAL LIABILITY SIR applies per policy ter ns & COndl ions PREMISES Ea occurrence $1,000,000 CLAIMS-MADE q OCCUR MED EXP (Any one person) $10,000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $2,000,000 X POLICY PE 0. L0C A AUTOMOBILE LIABILITY BAP 9265950-01 06/01/2011 06/01/2012 COMBINED SINGLE LIMIT $1 000 000 Business Automobile cover Ea accident , , X ANY AUTO BODILY INJURY ( Per person) ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS (Per accident) B X UMBRELLA LAB X OCCUR UMB926593701 06/01/2011 06/01/2012 EACH OCCURRENCE $25,000,000 EXCESS LIAB CLAIMS-MADE umbrella SIR applies per policy ter ns & condi ions AGGREGATE $25,000,000 DED X RETENTION $10,000 WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS' LIABILITY Y / N TORY LIMITS ER ANY PROPRIETOR/ PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? ? N / A E.L. EACH ACCIDENT (Mandatory in NH) E.L. DISEASE-EA EMPLOYEE DESCRIPTION OF OPERATIONS below E.L. DISEASE-POLICY LIMI DESCRIPTION OF OPERATIONS / 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. d w c m a a? O 2 m r Ln r- v 0 In O Z N f0 U N U ?r 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 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD