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CERTIFICATE OF LIABILITY INSURANCE I DATE(MM /DD /YYYY) 68/31/2011 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 2D certificate holder in lieu of such endorsement(s). PRODUCER CONTACT (D Aon Risk Services southwest, Inc. -NAME: PHONE 866) 2837122 A A/ INSURED INSURERA American Guarantee & Liability Ins Co 26247 GCC Energy, LLC INSURER B: Zurich American Ins Co 16535 4424 county Road 120 Hesperus CO 81326 USA INSURER C: Liberty Insurance underwriters, Inc. 19917 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570043660483 REVISION NUMBER: 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 CONTRACTOR 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. Limits shown are as requested IN SR LIMITS _6�TR TYPE OF INSURANCE ADD SUBIR POLICY EFF POLI E P _INSR WVD POLICY NUMBER (MMIDDIYYYY) (MWDDIYYYY) B GENERAL LIABILITY GL0655124102 0910112011 09/OT7n72 EACH OCCURRENCE $2,000,000 AGE To RENTED , M" COMMERCIAL GENERAL LIABILITY RE DAM 'ES (E. occurrence) $1,000,000 CLAIMS-MADE El OCCUR MED EXP (Any one person) $10,000 PERSONAL &ADV INJURY $1,000,000 Qo GENERAL AGGREGATE $4,000,000 GENI AGGREGATE LIMITAPPLIES PER PRODUCTS - COMP /OP AGG $4,000,000 co POLICY [:] PROJECT - [] LOC 0 11 I- B AUTOMOBILE LIABILITY BAP 6551242-02 09/01/2011 09/01/2012 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 ANY AUTO BODILY INJURY ( Per person) 0 z ALL OWNED SCHEDULED BODILY INJURY (Per accident) (D AUTOS AUTOS V. HIRED AUTOS NON-OWNED PROPERTY DAMAGE 0 AUTOS Per accident) 51000 C.11 D.d 51000 Comp Dcd C X UMBRELLA LIAB I X OCCUR UMBSF1875771 09/01/201109/01 /2012 EACH OCCURRENCE $25,000,000 0 EXCESS LIAB H CLAIMS-MADE AGGREGATE $25,000,000 DEDI IRETENTION - ----- A WORKERS COMPENSATION AND WC655124002 09/01/201109/01 /2012 X WC STATU- JOTH- EMPLOYERS' LIABILITY YIN TORY LIMITS JER ANY PROPRIETOR /PARTNER /EXECUTIVE F E.L. EACH ACCIDENT $2,000,000 0 FFICER/MEMBER EXCLU DEDI NIA (Mandatory in NH) E.L. DISEASE-EA EMPLOYEE $2,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE-POLICY LIMIT $2,000,000 Foi DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) See Attached: Re: OSM Permit CO-0106; CDRMS Permit CO-1981-035. CERTIFICATE HOLDER CANCELLATION MI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Colorado Division of Reclamation, AUTHORIZED REPRESENTATIVE Mining & safety 1313 Sherman street, Room 215 Denver co 80203 USA @1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD