2015-07-28_GENERAL DOCUMENTS - C1981044

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PEABENE-01 LEWISJY CERTIFICATE OF LIABILITY INSURANCE DATE (M/201YYY) 7/22/2015 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 Willis of Tennessee, Inc. c/o 26 Century Blvd(A/C.No P.O. Box 305191 CONTNAME: Willis Certificate Center PHONE g77 945-7378 FAX Ft): ) ac No): (888) 467-2378 E'ADDRESS: certifcates@willis.com Nashville, TN 37230-5191 INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:ACE American Insurance Company 22667 INSURED Peabody Energy Corporation and Subsidiaries INSURER B: EACH OCCURRENCE $ 5,000,000 Attn: Robert Fenley INSURER C: INSURER D: 701 Market Street Suite 700 St. Louis, MO 63101-1826 INSURER E, 08/01/2016 PAMAGE TO RENT-E-ff- REMISES Ea occurrence $ 100,000 INSURER F COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE ADDL INSD UB WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 5,000,000 CLAIMS-MADE[XI OCCUR HDOG27396367 08/01/2015 08/01/2016 PAMAGE TO RENT-E-ff- REMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL& ADV INJURY $ 5,000,000 GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 6,000,000 POLICY ❑ PRO JECT F—]LOCPRODUCTS - COMP/OPAGG $ 6,000,000 $ OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 6,000,000 Ea accident _ BODILYINJURY(Perperson) $ A X ANY AUTO ISAH08858299 08/01/2015 08/01/2016 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROP ERTYDAMAGE $ Per acadenl NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PEROTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED' N / A EL DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below EL DISEASE -POLICY LIMIT 1 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Moffett County Mining, LLC Including Permit C-81-044. IOL Z 8 Z01 ICN OF DMN1 N NG AND SAFE fY CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014/01) ©1988-2014 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. Colorado Division of Reclamation Mining and Safety AUTHORIZED REPRESENTATIVE 1313 Sherman Street_f Room 215 e�.Ih.�-� j �/ , ��"! Denver CO 80203 € ACORD 25 (2014/01) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD