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Page 1 of 2 <br />ACS") Q® <br />,���/�� CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM/D) <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />2o17 <br />oe/2s/2017 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND 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 have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />CONTACT <br />Willis of Tennessee, Inc. <br />NAME: <br />PHONE FAX <br />c/o 26 Century Blvd <br />1-877-945-7378 1-888-467-2378 <br />No ExO:jA/C No): _ <br />P.O. Box 305191 <br />E-MAIL certificates@willis.com <br />ADDRESS: <br />EACH OCCURRENCE <br />$ <br />Nashville, TN 372305191 USA <br />INSURER(S) AFFORDING COVERAGE NAIC# <br />INSURERA: ACE American Insurance Company 22667 <br />INSURED <br />Underwriters at Lloyd's London 15792 <br />INSURER 8: Y <br />Peabody Energy Corporation and Subsidiaries <br />- _ -_ -- - _ -_ <br />701 Market Street <br />INSURER C: <br />Suite 700 <br />INSURER D. <br />St. Louis, MO 631011626 <br />INSURERE,.____ <br />PREMISES (Ea occurrence)_ _ <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: W3331001 REVISION NUMBER: <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 OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS <br />INS R <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />SUBR <br />POLICY NUMBER <br />POLICY EFF <br />MM/DD/Yl'YY <br />POLICY EXP <br />MM/DD/YYYY <br />r <br />LIMITS <br />X I COMMERCIAL GENERAL LIABILITY2,000,000 <br />EACH OCCURRENCE <br />$ <br />CLAIMS -MADE - -OCCUR <br />DAMAGE TO RENTED <br />_ <br />2,000,000 <br />- I <br />PREMISES (Ea occurrence)_ _ <br />$ <br />A <br />ME_D_EXP (Any one person) <br />$__ <br />PERSONAL ADV INJUR__Y__ <br />_ <br />$ 2,000,000 <br />HDOG27870491 <br />08/01/2017 <br />08/01/2018 <br />_& <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />GEMLAGGREGATE LIMIT APPLIES PER <br />POLICY jE LOC <br />PRODUCTS - COMP/OP AGG <br />$ 2,000,000 <br />OTHER <br />$ <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />$ 2,000,000 <br />Ea accident <br />BODILY INJURY (Per person) <br />_ <br />$ <br />X <br />ANYAUTO <br />SCHEDULED <br />AUTOS ONLY AUTOS <br />ISAH09062725 <br />08/01/2017 <br />08/01/2018 <br />BODILY (Per <br />( ) <br />$ <br />HIRED NON-OWNEDPROPERTY <br />DAMAGE <br />$ <br />AUTOS ONLY AUTOS ONLY <br />Per accident <br />$ - <br />B <br />X <br />UMBRELLA LIAB X_ OCCUR <br />EACHOCCURRE_NCE <br />$ 3,000,000 <br />AGGREGATE <br />$ 3,000,000 <br />EXCESS LIAB 1- CLAIMS -MADE <br />B080117743U17 <br />08/01/2017 <br />'08/01/2018 <br />DED %� RETENTION $ 25, 000 <br />$ <br />WORKERS COMPENSATION <br />PER OTH- <br />AND EMPLOYERS' LIABILITY YIN <br />STATUTE ER <br />_ <br />L EACH ACCIDENT <br />$ <br />ANYPROPRIETOR/PARTNER/EXECUTIVEE <br />OFFICERIMEMBEREXCLUDED? ❑ <br />NIA <br />- — --- <br />EL DISEASE -EA EMPLOYEE <br />- ---- <br />$ <br />(Mandatory in NH) <br />If yes, describe under <br />----- <br />_-- -- <br />DESCRIPTION OF OPERATIONS below <br />E L DISEASE - POLICY LIMIT <br />$ <br />I <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />This Voids and Replaces Previously Issued Certificate Dated 07/27/2017 WITH ID: W3096478. <br />Named Insured includes Peabody Sage Creek Mining, LLC. <br />L,rKI Irtl.AIt MULULK GANGtLLAI IUN <br />Routt County Board of Commissioners <br />136 Sixth Street <br />P.O. Box 773840 <br />Steamboat Springs, CO 80477 <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 />AUTHORIZED REPRESENTATIVE <br />-q <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />SR ID* 14988031 ]BATCH: 426354 <br />