2012-07-23_GENERAL DOCUMENTS - C1992080

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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 ADDL INSR SUBR WVD POLICY NUMBER I POUCY EFF I POUCY EXP (MM /DD/YYYY) (MMIDD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY l J OCCUR 04GL000836698 12/5/2011 12/5/2012 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $100,000 i r j CLAIMS -MADE MED EXP (Any one person) $Excluded — _ — GEN'L X — PERSONAL 8 ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 AGGREGATE LIMIT APPLIES PER POLICY PRO- LOC lFCT PRODUCTS - COMP /OP AGG $2,000,000 $ A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED I AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS 04CA002786752 12/5/2011 12/5/2012 COMBINED SINGLE LIMI r (Ea accident) $1,000,000 BODILY INJURY (Per person) $ BODILY Peraccident ( ) $ PROPERTY DAMAGE (Per accident) $ A X UMBRELLA LIAB I OCCUR EXCESS LIAB I CLAIMS -MADE 04XS174142 12/5/2011 12/5/2012 EACH OCCURRENCE $1,000,000 AGGREGATE $1,000,000 DED X I RETENTION $10,000 $ g ' WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER OFFICER /MEMBER EXCLUDED/ (Mandatory in NH) If yes, descnbe under DESCRIPTION OF OPERATIONS Y / N N / A SBP0001027321 7/14/2012 /14/2013 WC STATU OTH TORY LIMITS ER /EXECUTIVE E L EACH ACCIDENT $1000000 below E L DISEASE - EA EMPLOYEE $1000000 E L DISEASE - POLICY LIMIT $1000000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Carbon Junction Coal Mine, CDRMS Permit #C -92 -080, Ewing Mesa, La Plata County, Colorado Certificate Holder will be given 30 day Notice of Cancellation 30 DNOC — 10 Non -Pay A CORO CERTIFICATE OF LIABILITY INSURANCE 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 Allred- Thompson- Mason - Daugherty Ins. A Division of Higginbotham Agency 1300 Tenth Street Wichita Falls TX 76301 INSURED Oakridge Energy Inc 4613 Jacksboro Hwy Wichita Falls TX 76302 OAKRI I O INSURER F : DATE (MM /DD/YYYY) 7/20/2012 NAME: Sylvia York INC " N Extr940- 723 -0771 FAX No).940- 723 -5309 E-MAIL INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :MI .- , n in -n In r - .m . -n INSURER B :Texas Mutual Insurance Co INSURER C : 22945 INSURER D : ' INSURER E : COVERAGES R ACORD 25 (2010/05) JUL 7 `? 201? pivls n gg a d Sa Safety Vining CERTIFICATE NUMBER: CANCELLATION • Colorado Division of Reclamation, Mining & Safety 1313 Sherman, 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 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD