2017-10-27_REVISION - C1982056 - Laserfiche WebLink

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_ Page 1 of 2 w c�►�.a� CERTIFICATE OF LIABILITY INSURANCE DoaizSizo �Y' 1 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(les) must have ADDITIONAL INSURED provisions or 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 NAME: Willie of Tennessee, Inc.X .._._. PHONE c/o 26 Century Blvd EMAIL '" I. 1-877-945-737$FAp�C"ryy�), P.O. Bax 305191 ADDRESS: certificates0willis.com Nashville, IN 372305191 USA INSURERS AFFORDING COVERAGE NAIC# INSURED Peabody Cinergy Corporation 701 Market Street Suite 700 St, Louis, MO 631011816 ACE American insurance Company 22667 Underwriters at Lloyd's Landon 15792 COVERAGES CERTIFICATE NUMBER: W3331000 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 e.,. TYPE OF INSURANCE ADOL SUER POLICY NUMBER POLICY DD YY POLICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE S 2.000,000 CLAIMS -MADE FX.,] OCCUR PREMISES Ea occurrence _ $ 2,000,000 MED EXP (Any one Person) $ A y HDOG27870491 08/01/2017 08/01/2018 PERSONAL &ADV INJURY S 2,000,000 GENERALAGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PERr PRODUCTS - COMPIOP AGG $ 2,000,000 PRO - POLICY .,...1 JECT LOC OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident S ANY AUTO BODILY INJURY gPer person) S AUTOS ONLY AUTOSWNEO r--7 BODILY INJURY P BODILY (Per accident) S ........ ....� HIRED NON -OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 3,000,000 B EXCESSLIAO CLAIMS-MADET1B080117743U17 08/01/2017 08/01/2018 AGGREGATE .....,.,_....................................._. $ 3,000,000 OED N` RETENTIONS 25,000 S WORKERS COMPENSATION TAT T RH AND EMPLOYERS` LIABILITY Y / N ANYPROPRIETORWARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICEWMEMSEREXCLUDED ? NIA _v__.........._.�.m._.,. __.......................... (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under "'"- DESCRIPTION OF OPERATIONS below IL E.L. DISEASE - POLICY LIMITS DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additionst Remarks Schedule, may be attached If mars space Is Taqulred) This Voids and Replaces Previously issued Certificate Dated 07/27/2017 WITH IDs W3096285. REt Twentymile Coal, 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 Twentymile Coal, LLC including CERTIFICATE HOLDER CANCELLATION oil Colorado Division of Reclamation, Mining and Safety 1313 Sherman Street, Room 215 ® //t Denver, Co 80203 ��4G 071968-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD SR To: 14988031 eATCH1 426354