2013-01-04_GENERAL DOCUMENTS - C2010089 (2)

Home Browse Search

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 SUBR POLICY EFF POLICY EXP INSR WVD POLICY NUMBER (MMIDD/YYYY) (MMIDDIYYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X OCCUR NAIC # INSURED Western Fuels Association, Inc. 12050 N. Pecos Street, Suite 100 Westminster, CO 80234 008844193 01/01/13 01/01/14 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100, 000 CLAIMS -MADE MED EXP (Any one person) $ X EBL $1,000,000 PERSONAL&ADVINJURY $ 1,000, 000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER' PRO X POLICY ,IFGT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 Employee Benefits $ 1,000,000 B AUTOMOBILE X X X LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CAB003292104 01/01/13 01/01/14 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ C X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE BE 12816139 01/01/13 01/01/14 EACH OCCURRENCE $ 25, 000, 000 AGGREGATE $ 25, 000, 000 X DEDUCTIBLE RETENTION $ 10 $ $ 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 I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Evidence of Insurance as respects New Horizon North Mine in Nucla, CO (Permit #C- 2010 -089). Includes use of Explosives RECEIVED Colorado Mined Land Reclamation Division of Reclamation, Mining 1313 Sherman Street, RM 215 Denver, CO 80203 1./r'IN U °t LU I3 Board Division of Reclomotior & Safety Mining & 9 Safety USA 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 PRODUCER 1 - 612 333 - 3323 Hays Companies 80 South 8th Street Suite 700 Minneapolis, MN 55402 ACORLf CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD/YYYY) 12/28/2012 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 1 - 612 333 - 3323 Hays Companies 80 South 8th Street Suite 700 Minneapolis, MN 55402 CONTACT NAME: PHONE FAX (NC No Extl• 612 - 333 -3323 (A/C, Nu); 612 - 373 - 7270 E -MAIL ADDRESS: PRODUCER CUSTOMERID #• INSURER(S) AFFORDING COVERAGE NAIC # INSURED Western Fuels Association, Inc. 12050 N. Pecos Street, Suite 100 Westminster, CO 80234 INSURER A: LEXINGTON INS CO 19437 INSURERS: ARCH INS CO 11150 INSURERC: NATIONAL UNION FIRE INS CO OF PITTS 19445 INSURERD. INSURER E : INSURER F : COVERAGES CERTIFICATE HOLDER CERTIFICATE NUMBER: 31036480 CANCELLATION REVISION NUMBER: ericj ACORD 25 (2009/09) 31036480 © 1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD