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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 <br />INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INSR <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />(MM /DD/YYYY) <br />POLICY EXP <br />(MM /DD/YYYY) <br />LIMITS <br />A <br />GENERAL <br />X <br />LIABILITY <br />COMMERCIAL GENERAL LIABILITY <br />INSURED <br />CHEVRON MINING, INC <br />116 INVERNESS DRIVE <br />SUITE 207 <br />ENGLEWOOD, CO 80112 <br />INSURER B <br />CMR G25839328 <br />03/01/2012 <br />03/01/2013 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />PR S ( RENTED <br />PREMISES (Ea occurrence) <br />$ <br />INSURER F : <br />X <br />CLAIMS -MADE <br />OCCUR <br />MED EXP (Any one person) <br />$ <br />PERSONAL & ADV INJURY <br />$ 1,000,000 <br />GENERAL AGGREGATE <br />$ 1,000,000 <br />GE <br />'L AGGREGATE <br />POLICY <br />LIMIT APPLIES <br />PRO- <br />JF(:T <br />PER <br />LOC <br />PRODUCTS - COMP /OP AGG <br />$ 1,000,000 <br />$ <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALL OWNED <br />AUTOS <br />HIRED AUTOS <br />SCHEDULED <br />AUTOS <br />NON -OWNED <br />AUTOS <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ <br />BODILY INJURY (Per person) <br />$ <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />A <br />X <br />UMBRELLA LIAB <br />EXCESS LIAB <br />X <br />OCCUR <br />CLAIMS -MADE <br />XLX G25839353 <br />03/01/2012 <br />03/01/2013 <br />EACH OCCURRENCE <br />$ 3,500,000 <br />AGGREGATE <br />$ 6,500,000 <br />DED <br />RETENT ON $ <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER /EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />Y / N <br />N / A <br />WC STATU- <br />TORY LIMITS <br />OTH- <br />ER <br />E L EACH ACCIDENT <br />$ <br />E L DISEASE - EA EMPLOYEE <br />$ <br />E L DISEASE - POLICY LIMIT <br />$ <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) <br />This Certificate shall provide for personal Injury and property damage as a result of surface coal mining and reclamation operations including arising from the use of explosives at the Insured "s Edna Mine in <br />Colorado. The Issuing Company shall notify the below named Certificate Holder whenever substantive changes are made in th- above descrbe• -. .. inc - rmination or failure to renew, within 30 days <br />I j A9104 <br />/coed"- v�Qi4D V� I � N s <br />j�i g A�au c©gOVINY <br />ACOR CERTIFICATE OF LIABILITY INSURANCE <br />Li...-/ <br />DATE(MM /DD/YYYY) <br />01/30/2012 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />MARSH RISK & INSURANCE SERVICES <br />345 CALIFORNIA STREET, SUITE 1300 <br />CALIFORNIA LICENSE NO 0437153 <br />SAN FRANCISC094104 <br />025158 -001 -- 007C <br />CONTACT <br />NAME: <br />( JC. PHONE . Eat). FAX No): <br />E -MAIL <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURER A ACE American Insurance Company <br />22667 <br />INSURED <br />CHEVRON MINING, INC <br />116 INVERNESS DRIVE <br />SUITE 207 <br />ENGLEWOOD, CO 80112 <br />INSURER B <br />INSURER C • <br />INSURER D <br />INSURER E - <br />INSURER F : <br />COVERAGES <br />CERTIFICATE HOLDER <br />ACORD 25 (2010/05) <br />CERTIFICATE NUMBER: <br />SEA - 002032363 - 42 <br />CANCELLATION <br />REVISION NUMBER: 17 <br />Division of Reclamation, <br />Minerals and Safety <br />Attn: Janet Binns <br />1313 Sherman Street, Room 215 <br />Denver, CO 80203 -2273 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />of Marsh USA Inc. <br />Wendy Sokol "7t).uc4 Q- <br />©1988 -2010 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />