Laserfiche WebLink
Ak °r CERTIFICATE OF LIABILITY INSURANCE <br />DATE <br />P �.ge 1 of 1 <br />08/01/2014 <br />/01/DD014 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND 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 Astatement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />CONTACT <br />NAME- <br />Willis of Tennessee, Inc. <br />c/o 26 Century Blvd. <br />P.O. Box 305191 <br />Nashville, TN 37230-5191 <br />PHONE 877 -945 -7378 FAX 888- 467 -237$ <br />-MAIL <br />certificates@willis.com <br />INSURERS)AFFORDINGCOVERAGE <br />NAIC# <br />INSURERA:ACE American Insurance Company <br />22667 -001 <br />$ 100,000 <br />INSURED <br />Peabody Energy Corporation and Subsidiaries <br />INSURER B: <br />PE ONAL &ADVINJURY <br />INSURER C: <br />Attn: Robert Fenley <br />701 Market Street <br />Suite 700 <br />INSURERD: <br />$ 6,000,000 <br />INSURERS: <br />PRODUCTS- COMP /OPAGG <br />St. Louis, NO 63101 -1826 <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER! 21RQRhn7 DFVIC1n1J ml Iunr -p- <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 OFSUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INS <br />TYPEOFINSURANCE <br />D' <br />SUB <br />POLICYNUMBER <br />POUCYEFF <br />POLICYEXP <br />LIMITS <br />A <br />GENERAL LIABILITY <br />$ COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE OCCUR <br />33DOG2733636A <br />/1/2014 <br />8/1/2015 <br />EACH OCCURRENCE` <br />$ 5 000 000 <br />GE 0 RENTED <br />RE ISE Eaoccurence <br />$ 100,000 <br />MEDEXP one person) <br />$ 5 000 <br />PE ONAL &ADVINJURY <br />$ 5,000,000 <br />GEN RALAGGREGATE <br />$ 6,000,000 <br />GEWLAGGREGATELIMITAPPLIESPER: <br />POLICY PRO- 7 LOC <br />PRODUCTS- COMP /OPAGG <br />$ 6 000 000 <br />AUTOMOBILE <br />LIABILITY <br />ANYAUTO <br />ALLOWNED SUTOS <br />HIRED AUTOS NON -OWNED <br />AUTOS <br />ISAH08827540 <br />/1/2014 <br />8/1/2015 <br />(CEe=5 INGLELIMIT <br />$ 5,000,000 <br />X <br />BODILY INJURY(Per person) <br />$ <br />BODILY INJURY(Peraccident) <br />$ <br />PRROPERTY AMAG <br />(Peracadent4 <br />$ <br />UMBRELLA LIAB <br />EXCESS LIAR <br />OCCUR <br />CLAIMS -MADE <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />DED I RETENTION$ <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETORIPARTNER/EXECUTIVE� <br />O0dFaFICER/MEMBHEtR EXCLUDED? <br />By ndatory descttbeuA <br />DESCRIPTIONOFOPERATIONSbelow <br />N/A <br />S A - - <br />RV l i <br />E.L. EACH ACCIDENT <br />$ <br />E.L. DISEASE -EA EMPLOYEE <br />$ <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach Acord 101, Additional Remarks Schedule, if more space is required) <br />Moffett County Mining, LLC Including Permit C -81 -044. <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 Division of Reclamation Mining and Safety AUTHOR17EDRF-PRESENTATIVE <br />1313 Sherman Street <br />Room <br />Denver, CO 80203 <br />Co11:4480066 Tp1:1848079 Cert:2 8 8607 © 1988- 2010ACORD CORPORATION. All rights reserved <br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD <br />