2011-07-22_GENERAL DOCUMENTS - C1984065 (2)

Home Browse Search

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. LT R TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM /DD /YYYY) (MM /DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY INSURED 1 , O ` C.B. Minerals Company, LLC 0 Z �' ' PO Box 1827 O { - ? ' �1O' cky Pebble Beach, CA 93953 " P+ " �' • INSURER B : 1X15286 07/12/2011 07/12/2012 EACH OCCURRENCE $ 500,000 PREMISES (Ea occu ence) $100,000 INSURER F : CA Resident License #0757776 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 X PD Ded:250 PERSONAL & ADV INJURY $500,000 GENERAL AGGREGATE $1,000,000 GEN'L AGGREGATE 7 POLICY LIMIT APPLIES PRO JECT PER: LOC PRODUCTS - COMP /OP AGG $1,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ - Wr STATU- TORY LIMITS OIH= ER _WORKERS_COMP.-ENSATION — AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Loc# 1 - Coal Ridge No. 1 Mine; New Castle, CO ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 07/21/2011 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 HUB International Ins Svcs Inc 2742 Crossroads Blvd Grand Junction, CO 81506 �� 970 245 -8011 � � CONTACT Melissa Jones NAME: PHOON , Ext): 303 - 382 - 5166 FAX 866- 243 -0727 (A/C, No): E -MAIL ADDRESS: melissa.jones@hubinternational.com INSURER(S) AFFORDING COVERAGE NAIL # INSURER A : EMC Insurance Companies 25186 INSURED 1 , O ` C.B. Minerals Company, LLC 0 Z �' ' PO Box 1827 O { - ? ' �1O' cky Pebble Beach, CA 93953 " P+ " �' • INSURER B : INSURER C: INSURER D : INSURER E INSURER F : CA Resident License #0757776 COVERAGES CERTIFICATE HOLDER Client #: 121429 CERTIFICATE NUMBER: CANCELLATION CBMINERA REVISION NUMBER: 218 L/O s State of Colorado Division of Minerals & Geology 1313 Sherman Street, Room 215 Denver, CO 80203 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 © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD