2012-12-18_GENERAL DOCUMENTS - C1981022

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Holder Identifier : 7777777707070700077763616065553330743517776215566507443137763504221073553476277122300745253633555020007703611062771113077740504217755030743710433763111207526277532076770077727252025773110777777707000707007 6666666606060600062606466204446200620002426224022006220026040262020062200260402620200622202404006002006220204262040220062200042422402000620222624024222206022026262000420066646062240664440666666606000606006 Certificate No : 570046528857 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 06/12/2012 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). 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. PRODUCER Aon Risk Services, Inc of Florida 222 Lakeview Avenue Suite 510 West Palm Beach FL 33401 USA PHONE(A/C. No. Ext): E-MAILADDRESS: INSURER(S) AFFORDING COVERAGENAIC # (866) 283-7122 INSURED Oxbow Mining, LLC 1601 Forum Place Suite 1400 West Palm Beach FL 33401-8101 USA 16535Zurich American Ins CoINSURER A: 40142American Zurich Ins CoINSURER B: INSURER C: INSURER D: INSURER E: INSURER F: FAX(A/C.No.):(847) 953-5390 CONTACTNAME: COVERAGES CERTIFICATE NUMBER:570046528857 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.Limits shown are as requested POLICY EXP (MM/DD/YYYY)POLICY EFF (MM/DD/YYYY)SUBRWVDINSR LTR ADDL INSR POLICY NUMBER TYPE OF INSURANCELIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS-MADEOCCUR POLICY LOC EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL &ADV INJURY GENERAL AGGREGATE PRODUCTS -COMP/OP AGG X X X GEN'LAGGREGATE LIMIT APPLIES PER: $1,000,000 $1,000,000 $10,000 $1,000,000 $5,000,000 $2,000,000 B 06/01/201206/01/2013 SIR applies per policy terms & conditions General Liablity GLO926594902 PRO- JECT AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS BODILY INJURY ( Per person) PROPERTY DAMAGE(Per accident) X BODILY INJURY (Per accident) $1,000,000A06/01/201206/01/2013 Business Automobile Cover COMBINED SINGLE LIMIT (Ea accident) BAP 9265950-02 EXCESS LIAB OCCUR CLAIMS-MADE AGGREGATE EACH OCCURRENCE DED UMBRELLA LIAB RETENTION E.L. DISEASE-EA EMPLOYEE E.L. DISEASE-POLICY LIMIT E.L. EACH ACCIDENT OTH-ERWCSTATU-TORY LIMITSY/N (Mandatory in NH) ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED?N/A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Elk Creek Mine Permit #1981 - 022 CANCELLATIONCERTIFICATE HOLDER AUTHORIZED REPRESENTATIVEDivision of ReclamationMining and Safety1313 Sherman StreetRoom 215Denver CO 80203 USA ACORD 25 (2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.