2017-08-02_GENERAL DOCUMENTS - C1992081

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^ Page 1 of 1 l ® DATE (MWDD/YYYY) A� R" CERTIFICATE OF LIABILITY INSURANCE 07/27/2017 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 ED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the to ons of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to f h Ider in lieu of such endorsement(s). PRODUCER CONTACT 1 NAME: Willis of Tennessee, Inc. O �O \ PHONE FAX c/o 26 Century Blvd P" E-MAIL 1-877-945-7378 1-886-467-2378 A/ No Ext): A/C No P.O. Box 305191 `-•r`t'QN ADDRESS: certificates@willis.com Nashville, TN 372305191 USA +O�1k, spi nl INSURERS AFFORDING COVERAGE NAICA ►�" „ pND Gt• INSURER A: ACE American Insurance Company 22667 INSURED INSURER B: Peabody Energy Corporation and Subsidiaries 701 Market Street INSURER C: Suite 700 INSURER D: St. Louis, MO 631011826 INSURER E INSURER F: rnvConr_oc CFQTICIr ATF NI IURPR- W3096276 RFVISII'1N NIIMRFR- 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 SUBR POLICY NUMBER POLICY MWDDNYYF MWDD EXP LIMITS X COMMERCIAL GENERAL LIABILITY /� ISL G�x7="d Denver, CO 802032273 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE � OCCUR PREMISES Ea occu ence $ 2,000,000 MED EXP (Any one person) $ A N N HDOG27870491 08/01/2017 08/01/2018 PERSONAL &ADV INJURY $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 POLICY F7 JECT PRO ❑ LOC $ OTHER, AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000 Ea accident BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ A OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY N N ISAH09062725 08/01/2017 08/01/2018 PROPERTY DAMAGE $ Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE STATUTE ER E.L EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED9 ❑ (Mandatory in NH) N/A DISEASE - EA EMPLOYEE $ _EL EL DISEASE - POLICY LIMIT $ If as, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Named Insured: Hayden Gulch Terminal, LLC Covers operations at Hayden Gulch Loadoul Facility including damage from surface coal, etc., Permit C-92-081. PicI IL9/+A TC U^1 n=o rA1JrCl 1 ATIniJ V lyt$t$-1Ulb AL;L)KLJ I:UKF'UKAI lUr4. All rignis reserve0. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SR ID: 14889283 BATCH: 397018 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 Department of Natural Resources Division of Reclamation, Mining and Safety AUTHORIZED REPRESENTATIVE Room 215 1313 Sherman Street /� ISL G�x7="d Denver, CO 802032273 V lyt$t$-1Ulb AL;L)KLJ I:UKF'UKAI lUr4. All rignis reserve0. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SR ID: 14889283 BATCH: 397018