2014-08-11_GENERAL DOCUMENTS - C2009087

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)DV--A a� °® CERTIFICATE OF LIABILITY INSURANCE page 1 of 1 081`01/2014 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 Willis of Tennessee, Inc. c/o 26 Century Blvd. P.O. Box 305191 Nashville, TN 37230 -5191 CONTACT NAME: PHONE FAX AC No EXT: 877- 945 -7378 AC NO): 888- 467 -2378 E -MAIL ADDRESS: CertlflCateB@W] 1118. COm INSURER(S)AFFORDING COVERAGE NAIC # INSURERA:ACE American Insurance Company 22667 -001 8/1/2014 INSURED Peabody Energy Corporation INSURERB: $ 51000,000 INSURERC: $ 100,000 Attn: Robert Fenley 701 Market Street Suite 700 INSURER D: INSURER E: St. Louis, MO 63101 -1826 INSURER F: CLAIMS -MADE OCCUR COVERAGES CERTIFICATE NUMBER: 21898658 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 TVPEOFINSURANCE ADD'L INSR SUBR WVD POLICY NUMBER POLICY EFF M D VYY ) POLICY EXP (MWDD[YYYYI LIMITS A GENERAL LIABILITY y HDOG2733636A 8/1/2014 8/1/2015 EACHOCCURRENCE $ 51000,000 PREMI ETORENTED PREMISES Eaoccurence $ 100,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR MED EXP (Anyone person) $ 5,000 PERSONAL& ADV INJURY $ 5,000,000 GENERAL AGGREGATE $ 6,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 6,000,000 $ POLICY PE O LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Eaaccident) $ BODILY INJURY(Per person) $ ANY AUTO ALLOWNED SCHEDULED AUTOS NON-OWNE HR DAUTOS AUTOS ED BODILY INJURY(Per accident) $ DAMAGE Pera ident $ $ UMBRELLA LIAB OCCUR AV 1 EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE 12014 DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUINE" OFFICER /MEMBER EXCLUDED? ((Mandatory in NH) ff yes, describe under DESCRIPTION OF OPERATIONS below N/A eClamatl rv,llIng& On, Safety 7 I 15TH TORY LIMITS ER E. L. EACH ACCIDENT $ $ E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (Attach Acord 101, Additional Remarks Schedule, if more space is required) Re: Peabody Sage Creek Mining, LLC It is agreed that Colorado Division of Reclamation, Mining and Safety is included as an Additional Insured as respects to General Liability where required by contract or agreement. Covers operations at Peabody Sage Creek Mining, LLC including the use of explosives. CERTIFICATE HOLDER CANCELLATION Coll:4480066 Tpl:1848072 Cert:218 -38658 © 1988- 2010ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 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. AUTHORIZED REPRESENTATIVE Colorado Division of Reclamation, Mining and Safety 1313 Sherman Street, Room 215 ' Denver, CO 80203 Coll:4480066 Tpl:1848072 Cert:218 -38658 © 1988- 2010ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD