2011-06-17_GENERAL DOCUMENTS - C1983059 (2)

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A?RO® 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 Ri k S i f l id NAME: s erv ces, Inc o F or a FAX PHONE 866 222 Lakeview Avenue ( ) 283-7122 (847) 953-5390 (A/C. No• Et): C. No.): 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 e Suite 1400 oq INSURER C: ? west Palm Beach FL 33401-8101 USA INSURER D: INSURER E: INSURER F : °' w m a d 'o 0 S kluv]=KAUCJ L,tKIII-IL.AIW_-NUPA t$ .57 :b //y/ KEV151UN NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSU I TJ LOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREM$?1 I CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, TH SURANCE 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 MMIDDNYYY MM/DD/YYYY LIMITS A GENERAL LIABILITY GLO - 66/01/201T 77/717= EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY General Llablity DA A E RENTED $1 000 000 SIR applies per policy ter ns & condl ions PREMISES Ea occurrence , , CLAIMS-MADE 1XI OCCUR MED EXP (Any one person) $10,000 PERSONAL B ADV INJURY $1,000,000 rn GENERAL AGGREGATE $5,000,000 r- GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $2,000,000 X POLICY PR? LOC r- 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) Z ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) y PROPERTY DAMAGE HIRED AUTOS NON-OWNED U AUTOS (Per accident) Q B X UMB x UMB926593701 06/01/2011 06/01/2012 EACH OCCURRENCE $25 000 nnn U RELLA LIAR OCCUR , EXCESS LIAR CLAIMS-MADE Umbrella AGGREGATE $25,000, SIR applies per policy terns & condi ions DED X RETENTION S10. 000 WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS' LIABILITY Y / N TORY LIMITS ER ANY PROPRIETOR / PARTNER, EXECUTIVE E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? ? N / A (Mandatory in NH) _ E.L. DISEASE-EA EMPLOYEE Ryas. 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 Reclamation, Mining and safety is included as an Additional insured excluding workers' Compensation and Employers' Liability 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. CERTIFICATE HOLDER CANCELLATION r SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE ti POLICY PROVISIONS. Division of Reclamation, Mining AUTHORIZED REPRESENTATIVE and safety Denv 1313 Sherman Street, Room 215 Denver CO 80203 USA :?tDfip ? 'soda ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD