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2013-11-06_GENERAL DOCUMENTS - C1982057 (3)
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2013-11-06_GENERAL DOCUMENTS - C1982057 (3)
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Last modified
8/24/2016 5:37:05 PM
Creation date
11/6/2013 1:00:16 PM
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DRMS Permit Index
Permit No
C1982057
IBM Index Class Name
GENERAL DOCUMENTS
Doc Date
11/6/2013
Doc Name
Certificate of Liability Insurance
To
DRMS
Media Type
D
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No
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LA G,2) Z -bs? <br />741-S <br />A� °® CERTIFICATE OF LIABILITY INSURANCE page 1 of 1 <br />10/3 /2013 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />CONTACT <br />E <br />Willis of Tennessee, Inc. <br />c/o 26 Century Blvd. <br />P.O. Box 305191 <br />___ <br />PHONE FAX <br />877- 945 -7378 t NO)= 888 - 467 =2378_ <br />EMAIL certificates@willis.com <br />Nashville, TN 37 23 0 -5191 <br />INSURER(S)AFFORDING COVERAGE <br />NAIC'# <br />�INSURERA ACE American Insurance Company <br />22667 -001 <br />INSURED Peabody Energy Corporation and Subsidiaries INSURER <br />GENERAL AGGREGATE <br />$ 61000,000 <br />Attu: Robert Fenley INSURERC <br />701 Market Street <br />Suite 700 INSURERD: <br />$ 6,000,000 <br />St. Louis, NO 63101 -1826 INSURERE. <br />• <br />INSURER F. <br />COVERAGES CERTIFICATE NUMBER:20640042 REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />IN SR TYPE OF INSURANCE <br />TR <br />D' <br />SUB <br />w"D <br />POLICYNUMBER I POLICY EFF <br />POLICY EXP <br />LIMITS <br />• <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS - MADE❑$ OCCUR <br />Division of Reclamation, Mining and Safety <br />Room 215 <br />EDOG2732809A <br />11/1/2013 <br />11/1/2014 <br />EACH OCCURRENCE is 5,000,000 <br />DAMAG TO RENTED <br />PREMIS S Eaoccure ce Is 100,000 <br />MED EXP(Any we person) ,S 5,000 <br />PERSONAL &ADVINJURY <br />S 51000,000 <br />GENERAL AGGREGATE <br />$ 61000,000 <br />�GEWL AGGREGATE LIMIT APPLIES PER: <br />POLICY PRO- <br />.lFr.T 171 LOC <br />PRODUCTS - COMP /OP AGG <br />$ 6,000,000 <br />$ <br />• <br />AUTOMOBILE LIABILITY <br />X ANY AUTO <br />ALL AUTOS S TOSULED <br />NON-0WNED <br />HIRED AUTOS AUTOS <br />ISAH08815306 <br />// <br />1GP" <br />11/l/2013 <br />® <br />11/l/2014 <br />CO(Ea aBINEDMcodwt) ANGLE LIMIT <br />) <br />$ 5,000,000 <br />BODILY INJURY(Per Person) <br />$ <br />BODILY INJURY(Peracodent) <br />S -_ -- <br />PROP R DAMAG <br />(Peracddenq <br />S <br />!S <br />UMBRELLA LIAR <br />EXCESS L1AB <br />OCCUR <br />CLAIMS -MADE <br />„y j,�`� r% of <br />f �,{ L. <br />EACH OCCURRENCE <br />is <br />AGGREGATE <br />Is <br />DED I RETENTION$ <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETORIPARTNERIEXrCUTIVE(�1 <br />Myye�ssC ry EMBER EXCLUDED? I—! <br />DESCRRIPPTTIION OF OPERATIONS below <br />NIA <br />l" '-7 vC <br />9�JIS�O tti y <br />M1�t1 +~ <br />/ <br />E.L. EACH ACCIDENT <br />$ <br />EL DISEASE -EA EMPLOYEE <br />$ <br />E.L. DISEASE - POLICY LIMIT <br />Is <br />I <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VB41CLES (Attach Acord 101, Additoml Remarks Schedule, N more space is required) <br />Named Insured: Seneca Coal Co., a Subsidiary <br />Covers operations at Seneca II -W Hine including damage from surface coal mine operations, the use <br />of explosives and damage to water wells. <br />CERTIFICATE HOLDER CANCELLATION <br />C011:4253132 Tpl:1725220 Cert:26M042 © 1988- 2010ACORDCORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Colorado Department of Natural Resources <br />AUTHORREO REPRESENTATIVE <br />Division of Reclamation, Mining and Safety <br />Room 215 <br />1313 Sherman Street <br />Denver, CO 80203 -2273 <br />C011:4253132 Tpl:1725220 Cert:26M042 © 1988- 2010ACORDCORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />
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