2012-03-12_REVISION - C1981019 - Laserfiche WebLink

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. LTR TYPE OF INSURANCE ADDL W INSR S VD POLICY NUMBER (MM /DD (MM /DD/YYYY) LIMITS A GENERALLIABIUTY COMMERCIAL GENERAL LIABILITY OCCUR 1NSURER(S) AFFORDING COVERAGE NAIC # 008844193 01 /01 /12 01/01/13 EACH OCCURRENCE $ 1,000,000 X DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100, 000 CLAIMS -MADE X MED EXP (Any one person) $ X EBL $1,000,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2 , 0 0 0 , 0 00 JECT LOC 7 POLICY PRO I I Employee Benefits $ 1,000,000 B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CAB003292103 01/01/12 01/01/13 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ $ C X UMBRELLAUAB EXCESS LIAB X OCCUR CLAIMS -MADE BE12816074 01/01/12 01/01/13 EACH OCCURRENCE $ 25,000,000 AGGREGATE $ 25, 000, 000 DEDUCTIBLE RETENTION $ 10,000 $ X $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERJEXECUTIVE OFFICER/MEMBER EXCLUDED'? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS Y/ N N / A WC STATU- OTH- TORY LIMITS ER E.L EACH ACCIDENT $ ( E L DISEASE - EA EMPLOYEE $ below E L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Evidence of Insurance as respects Colowyo Coal Company, L.P. (Permit #C -81 -019). Includes use of Explosives � CERTIFICATE IL IT INSURANCE DATE(nRiAYY) 03/06/2012 2012 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 1- 612 - 333 -3323 Hays Companies 80 South 8th Street Suite 700 Minneapolis, MN 55402 CONTACT NAME: PHONE 612 - 333 - 3323 FAX 612 - 373 - 7270 (A/C. No. Ext): (A(C, No): E -MAIL ADDRESS: PRODUCER CUSTOMER ID #: 1NSURER(S) AFFORDING COVERAGE NAIC # INSURED Western Fuels Association, Inc. 12050 N. Pecos Street, Suite 100 Westminster, CO 80234 INSURERA: LEXINGTON INS CO 19437 INSURERB: ARCH INS CO 11150 INSURERC: NATIONAL UNION FIRE INS CO OF PITTS 19445 INSURER D : INSURER E : INSURER F : CERTIFICATE HOLDER jhargrove ACORD 25 (2009/09) 25997335 ER: 25997335 CANCELLATION REVISION NUMBER: Colorado Mined Land Reclamation Mined Land Division 1313 Sherman Street, RM 215 Denver, CO 80203 USA 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 © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD