2012-09-27_GENERAL DOCUMENTS - C1981014 (2)

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ENERG -1 OP ID: T5 144C°RD CERTIFICATE OF LIABILITY INSURANCE D 2 AT0 /25// 09/25/12 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 Phone: 970-879-1363 Brown & Brown Insurance 675 Snapdragon Way, Suite 200 Fax: 970 - 879 -0239 Steamboat Springs, CO 80487 Todd A. Hayes NAMEACT a °NN Ext ac No), E -MAIL ADDRESS I INSURER(S) AFFORDING COVERAGE NAIL # INSURER Great Midwest Insurance Co 18694 INSURED Energy Fuels Corporation Lindsay Yates PO Box 773457 INSURER B INSURER C INSURER D. Steamboat Springs, CO 80477 -3457 INSURER E 10101/12 10/01/13 INSURER F $ 100 00 MED EXP (Any one person) COVERAGES CERTIFICATE NUMBER: 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 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 ADDLISUBR POLICY NUMBER POLICY EFF MM /DD/YYYY POLICY EXP MM /DD/YYYY LIMITS GENERAL LIABILITY _ EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE AV II OCCUR GL00011080 10101/12 10/01/13 DAMAGE TO RENTED PREMISES Ea occurrence $ 100 00 MED EXP (Any one person) $ 5,00 PERSONAL BADVINJURY $ 1,000,00 Employee Benefits GENERAL AGGREGATE j $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 2,000,00 $ POLICY 7 PRO- LOD AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Peracc" t $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABiLiTY �Y / N ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? N/A T RY LIMITS FR E L EACH ACCIDENT $ E L DISEASE - EA EMPLOYEEI $ (Mandatory in NH) If yes describe under DESCRIPTION OF OPERATIONS below E L DISEASE -POLICY LIMIT $ I I i I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Reference: Kerr Mine: Permit #C -80 -006 R and Southfield Mine - Permit #C -81 -014. S101 e�a�ac�o�, S\OX\ K CNATURA Colorado Division of Reclamati Mining and Safety Division of Minerals & Geology 1313 Sherman Street, Rm 215 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. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD