2012-07-05_GENERAL DOCUMENTS - C1981013

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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 ADD'L INSRD SUBS WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY INSURED Basin Resources, Inc. Attn: Chuck Finkenstadt 9540 South Maroon Circle Suite 200 Englewood, CO 80112 I INSURER B• GL0654147903 GCi`� V 7/1/2012 ID GENERAL 7/1/2013 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurence) $ 1,000,000 INSURER F CLAIMS -MADE g OCCUR MED EXP (Any one person) $ 10,000 $ 1,000,000 PERSONAL &ADV INJURY AGGREGATE $ 2,000,000 GEN'L AGGREGATE 7 POLICY LIMITAPPLIESPER: JE 0 LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED H/REDAUTOS SCHEDULED NON-OWNED AUTOS \�` 0� 7� v`d ety t\ VON\s`• V\gan� �(\ \n �� COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY(Per person) $ $ PROPERTYDAMAGE�Ident) (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ E L DISEASE - EA EMPLOYEE $ E.L DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (Attach Acord 101, Additonal Remarks Schedule, if more space is required) RE: The Golden Eagle Mine - Permit #C -81 -013 A ° f CERTIFICATE OF LIABILITY INSURANCE Page 1 of 1 06/2 /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 Willis of Tennessee, Inc. c/o 26 Century Blvd. P. 0. Box 305191 Nashville, TN 37230 -5191 CONTACT NAME: PHONE FAX (ANC. NO. EXT) 877 - 945 -7378 (A(C,N0). 888- 467 -2378 ADDR certificates@Willis.com INSURER(S)AFFORDING COVERAGE NAIC # INSURERA Zurich American Insurance Company 16535 -000 INSURED Basin Resources, Inc. Attn: Chuck Finkenstadt 9540 South Maroon Circle Suite 200 Englewood, CO 80112 I INSURER B• INSURERC INSURER D: INSURER E. INSURER F COVERAGES CERTIFICATE HOLDER ACORD 25 (2010/05) CERTIFICATE NUMBER: 18155600 CANCELLATION REVISION NUMBER: State of Colorado Attn: Joseph Dudash Mined Land Reclamation Office 1313 Sherman Street, 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 REPRESENTATIVE Co11:3781068 Tp1:1480067 Cert:18155600 ® 1988- 2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD