2015-08-05_GENERAL DOCUMENTS - C1981019

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ACC>R " CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY) 7/30/2015 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 Hays Companies Ruan Center, 666 Grand Avenue 17th Floor Des Moines IA 50309 CONTACT Lace Skalick NAME: y y PHONE Ext,(515) 802-3006 ac No: ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A:Lexin ton Insurance Com an INSURED COLOWYO COAL COMPANY L.P. 1100 West 116th Ave Westminster CO 80234 INSURER B :National Union Fire Ins. Co INSURER C: INSURER D: INSURER E: INSURER F, CnVFRAnPR CFRTIFICATF Nt1MBFR2015 - 2016 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 LTRlullwa TYPE OF INSURANCE AD UBR NUMBER POLICPOLICY MM/DDYEFF /YYYY MM DD/YYYY EXP LIMITS GENERAL LIABILITY James Hays/ANAPOL_-- EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 100 000 PREMISES Ea occurrence $ MED EXP (Any one person) $ A CLAIMS -MADE OCCUR2139�p. /1/2015 /1/2016 PERSONAL &ADV INJURY $ 1,000,000 MECEC GENERAL AGGREGATE $ 2,000,000 AUG 0.5 2015 GENT AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OPAGG $ 2,000,000 $ POLICY PRO X LOC AUTOMOBILE LIABILITY ANY AUTO UIVISECLA.� 1,1IINII NG AND ` r ��r(0 AFEE COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS PROPERTY PERTDAMAGE $ accident) $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 25,000,000 AGGREGATE $ 25,000,000 B EXCESS LIAB CLAIMS -MADE DED I X I RETENTION$ $10,OOC $ BE84160099 8/1/2015 /1/2016 WORKERS COMPENSATIONWC AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE STATU- OTH- LIMITSRY E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N / A E L DISEASE - EA EMPLOYE $ E L DISEASE - POLICY LIMIT $ If yes describe under DESCRIPTION OF OPERATIONS below I I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Evidence of Insurance as respects Colowyo Coal Company, L.P. (Permit #C-81019). Includes use of Explosives CFRTIFIRATF wni n;:p CANCELLATION ACORD 25 (2010/05) INS025 mmnnsi m ©1988-2010 ACORD CORPORATION. All rights reserved. The Arr)Pn nmma nnrl Innn ern rnniafarnrl mnrlra of Arr)Pn SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Colorado Mined Land Reclamation Mined Land Division AUTHORIZED REPRESENTATIVE 1313 Sherman Street, RM 215 Denver, CO 80203 James Hays/ANAPOL_-- ACORD 25 (2010/05) INS025 mmnnsi m ©1988-2010 ACORD CORPORATION. All rights reserved. The Arr)Pn nmma nnrl Innn ern rnniafarnrl mnrlra of Arr)Pn