2016-08-11_GENERAL DOCUMENTS - C2009087

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PEABENE-01 GHADEPO '4k. R CERTIFICATE OF LIABILITY INSURANCE ATE (M 7/27//201201 YYY) P6 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. /► \�E c/o 26 Century Blvd ■V- J`e P.O. Box 305191 Nashville, TN 37230-5191 1 U 1 Ni NAME: Willis Towers Watson Certificate Center NAME: PHONE FAX A/c No Ext : (877) 945-7378 A No : (888) 467-2378 E-MAIL ADDRESS: certificates@willis.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A:Ironshore Specialty Insurance Company 25445 AUG INSURED SION OF RECI.AMA� ��/ Peabody Energy Corporatio�lM EV INSURER B 1 � n NID S9 701 Market Street MINING f'�� INSURER C : CLAIMS -MADE 1K OCCUR Suite 700 INSURER D : INSURER E: St. Louis, MO 63101-1826 INSURER F: DAMAGE REN D 5,000 000 PREMISES Ea occurrence $ , 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 I TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MMIDD POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 5,000,000 CLAIMS -MADE 1K OCCUR X 002860600 08/01/2016 08/01/2017 DAMAGE REN D 5,000 000 PREMISES Ea occurrence $ , MED EXP (Anyone person) $ PERSONAL & ADV INJURY $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 5,000,000 POLICY ❑ JE T 1-1 LOC PRODUCTS - COMP/OP AGG $ 5,000,000 $ OTHER. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS INJURY Per accident $ BODILY ( ) HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE $ Per accident UMBRELLA LIAR OCCUR EACH OCCURRENCE $ [] EXSS LIAR CLAIMS -MADE AGGREGATE $ :DECD RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITYY / N STATUTE I I ER E L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED NIA I E L 013r^3r CA CM (Mandatory in NH) If yes, descnbe under DESCRIPTION OF OPERATIONS below E L DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached 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 Colorado Division of Reclamation, Mining and Safety 1313 Sherman Street, Room 215 Denver, CO 80203 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 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD