2011-12-05_GENERAL DOCUMENTS - C1992080

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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 INSR SUBR WVD POLICY NUMBER POLICY EFF (MMIDD/YYYY) POLICY EXP (MMIDD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY 04GL000836698 12/5/2011 12/5/2012 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $100,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $Excluded PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GENL AGGREGATE 7 POLICY LIMIT APPLIES PER: PIFRO X LOC PRODUCTS - COMP /OP AGG $2,000,000 $ A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON-OWNED AUTOS 04CA002786752 12/5/2011 12/5/2012 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE 04XS174142 12/5/2011 12/5/2012 EACH OCCURRENCE $1,000,000 AGGREGATE $1,000,000 DED X RETENT ON $10,000 $ B -- WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICEPJ!.MEMBER- EXCLUDED ? - Y / N N/A SBP0001027321 7/14/2011 7/14/2012 X WC STATU- OTH- TORY LIMITS FR E.L. EACH ACCIDENT $1,000,000 $1,000;000 - -- - (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - EA EI IPLOt'EE E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Carbon Junction Coal Mine, CDRMS Permit #C -92 -080, Ewing Mesa, La Plata County, Colorado ��, Certificate Holder will be given 30 day Notice of Cancellation. �e 30 DNOC —10 Non -Pay. DEC OS 2011 ,,ta ma°n , OMS:►Orl ° and Safety ACORD 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 Allred- Thompson- Mason - Daugherty Ins. A Division of Higginbotham Agency 1300 Tenth Street Wichita Falls TX 76301 INSURED Oakridge Energy Inc 4613 Jacksboro Hwy Wichita Falls TX 76302 CERTIFICATE OF LIABILITY INSURANCE OAKRI1 CONTACT NAME: Debbie Bachman PHONE (NC. No. Fat):940- 723 -0771 E -MAIL ADDRESS:debbieb @atmd i nsurance.com INSURER(S) AFFORDING COVERAGE INSURER A:Mid Continent Insurance Company I NSURER B :Texas Mutual Insurance Company INSURER C : INSURER D : INSURER E : INSURER F : DATE (MMIDD/YYYY) 11/30/2011 FAX No):940- 723 -5309 NAIC # COVERAGES CERTIFICATE HOLDER ACORD 25 (2010/05) CERTIFICATE NUMBER: 1598317055 CANCELLATION REVISION NUMBER: Colorado Division of Reclamation, Mining & Safety 1313 Sherman, 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 R PRESENTATIVE @ 1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD