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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 Limits shown are as requested <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INSR <br />SUBR <br />MD <br />POLICY NUMBER <br />POLICY EFF <br />(MMIDD/YYYY <br />POLICY EXP <br />MMIDD/YYYY) <br />LIMITS <br />B <br />GENERAL LIABILITY <br />INSURER A. Zurich American Ins Co <br />16535 <br />GL0926594902 <br />General Liablity <br />SIR applies per policy terns <br />b6 /01 /201 <br />& condi <br />6/01/1013 <br />:ions <br />EACH OCCURRENCE <br />$1,000,000 <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE n OCCUR <br />DAMAGE lORENiLD <br />PREMISES (Ea occurrence) <br />$1,000,000 <br />MED EXP (Any one person) <br />$10,000 <br />PERSONAL & ADV INJURY <br />$1,000,000 <br />GENERAL AGGREGATE <br />$5,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />POLICY ■ PRO- x LOC <br />IFCT I I <br />PRODUCTS - COMP /OP AGG <br />$2,000,000 <br />A <br />AUTOMOBILE LIABILITY <br />BAP 9265950 - 02 <br />Business Automobile Cover <br />06/01/2012 <br />06/01/2013 <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$1,000,000 <br />X <br />_ <br />ANY AUTO <br />BODILY INJURY ( Per person) <br />ALL OWNED <br />AUTOS <br />HIRED AUTOS <br />— <br />_ <br />_ <br />SCHEDULED <br />AUTOS <br />NON -OWNED <br />AUTOS <br />BODILY INJURY (Per accident) <br />PROPERTY DAMAGE <br />(Per accident) <br />C <br />X <br />— <br />UMBRELLA LIAR <br />EXCESS LIAB <br />X <br />OCCUR <br />CLAIMS -MADE <br />UMB926593702 <br />umbrella <br />SIR applies per policy terns <br />06/01/2012 <br />& condi <br />06/01/2013 <br />:ions <br />EACH OCCURRENCE <br />$25,000,000 <br />AGGREGATE <br />$25,000,000 <br />DED I X !RETENTION 310 000 <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />N / A <br />WC STATU- <br />TORY LIMITS <br />OTH- <br />ER <br />ANY PROPRIETOR / PARTNER / EXECUTIVE <br />OFFICER/MEMBER EXCLUDED <br />(Mandatory in NH) <br />Y I N <br />E L EACH ACCIDENT <br />E L DISEASE -EA EMPLOYEE <br />If yes, descnbe under <br />DESCRIPTION OF OPERATIONS below <br />E L DISEASE- POLICY LIMIT <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />RE: Permit number C - 1983 -059 ' Terror Creek Loadout " <br />Division of Reclamation, Mining and Safety is included as Additional Insured as required by written contract, but limited to <br />the operations of the Insured under said contract, per the applicable endorsement with respect to the Auto, GL and UMB policy. <br />A 16.- aRU e CERTIFICATE OF LIABILITY II I Ia RA� ty <br />DATE 2 / 2YYY) <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO R U PON 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 />Aon Risk Services, Inc of Florida <br />222 Lakeview Avenue <br />Suite 510 <br />west Palm Beach FL 33401 USA <br />CONTACT <br />NAME: <br />PHONE (866) 283 -7122 I FAX (847) 953 -5390 <br />( NC. No Ex t) (NC No.): <br />E -MAIL <br />ADDRESS. <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURED <br />Terror Creek LLC <br />1601 Forum Place <br />Suite 1400 <br />West Palm Beach FL 3 3401 -8 101 USA <br />INSURER A. Zurich American Ins Co <br />16535 <br />INSURER B: American Zurich Ins Co <br />40142 <br />INSURER C: American Guarantee & Liability Ins Co <br />26247 <br />INSURER D: <br />INSURER E: <br />INSURER F: <br />COVERAGES <br />CERTIFICATE HOLDER <br />Division of Reclamation, Mining <br />and Safety <br />1313 Sherman Street, Room 215 <br />Denver CO 80203 USA <br />CERTIFICATE NUMBER: 570046528807 <br />CANCELLATION <br />AUTHORIZED REPRESENTATIVE <br />RECEIVED t <br />JUN 1 2 7f1? <br />. C lamation , <br />REVISION NUMBER: <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE <br />POLICY PROVISIONS. <br />©1988 -2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />