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Page 1 of 2 <br />.���0 <br />"+��4•••...•••,,, ��� CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMV12017Y) <br />0$/2S/2,�17 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) 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 />NAME: , <br />PHONEFAX <br />. 1-877-945-7378 AIC Nob1-888-467 2378 <br />Millis of Tennessee, Inc. <br />c/o 26 Century Blvd <br />P.O. Box 305191 <br />Ea,1 1L <br />ADDRE , cortificatesllneillis,com <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />Nashville, TH 372305191 USA <br />INSURER A; ACE American insurance Company <br />22667 <br />EACH OCCURRENCE $ 2,000,000 <br />INSURED <br />INSURER B. Underwriters at Lloyd -s London <br />15792 <br />Peabody Energy Corporation and Subsidiaries <br />701 Market Street <br />INSURER C; <br />MED EXP (Any one person) $ <br />INSURER D; <br />Suite 700 <br />t145URER E <br />St. Louis, MO 63101,1&26 <br />INSURER F; <br />PERSONAL a ADV INJURY $ 2.040.004 <br />COVERAGES CERTIFICATE NUMBER: W3331001 REVISION NUMBER: <br />THIS IS TO CtPTIFY 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 />tLT. <br />LTR <br />TYPE OF INSURANCE <br />P,CNSD <br />sU <br />POLICY NUMBER �_.�. <br />YY <br />MIPULlDIYYY <br />EXP <br />MMFF iIClYYYY <br />LIMITS <br />X COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE $ 2,000,000 <br />CLAIMS-MAIyF ' OCCUR <br />PREMISES(Ea rxcurrrence S 2,000.000 <br />MED EXP (Any one person) $ <br />A <br />PERSONAL a ADV INJURY $ 2.040.004 <br />HDO027870491 <br />08/01/2017 <br />08/01/2018 <br />GENERAL AGGREGATE S z'000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />PRODUCTS-COMP/OPAGG S 2,000,000 <br />POLICY 1, � CT _LOC <br />$ <br />OTHER <br />I <br />I <br />AUTOMOBILE LIABILITY <br />OMBINEDIN13LE LIMIT S 2,000,000 <br />E acadent! <br />BODILY INJURY (Per person) S <br />X ANY AUTO <br />OWNEA AUTOS AUTOSSCHEDLEO <br />AUTOS ONLY AUTOS <br />ISAH09062725 <br />08'-/01/2017 <br />08/01/2018 <br />BODILY INJURY (Per accident) $ <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE $ <br />Per en <br />$ <br />B <br />X <br />UMBRELLA LIAS <br />EXCESSLIAB <br />?: OCCUR <br />FD CLAIMS -MADE <br />B080117743V17 <br />06/01/2017 <br />08/01/2018 <br />EACH OCCURRENCE $ 3,000,000 <br />_ <br />AGGREGATE S _3,000,000 <br />DED J X I RETENTION$ 25,000 <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANYPROPRIETORIPARTNER/EXECUTIVE <br />7 <br />F <br />TAT TE ER <br />E.L. EACH ACCIDENT S <br />OFFIGERtMEM6EREXGLUDEO? <br />NWA, <br />(Mandatory M NH) <br />E.L. DISEASE - EA EMPLOYEE S <br />E.L. DISEASE - POLICY LIMIT $ <br />It yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />! <br />DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES IACORD 101, Additions$ Remarks Schedule, may be attached if more space is nqulred) <br />This voids and Replaces Previously Issued Certificate Dated 07/27/2017 WITH IDt W3096478. <br />Named Insured includes Peabody Sage Creek Mining, LLC. <br />CERTIFICATE HOLDER CANCELLATION <br />0 1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />sa YD: 14988031 BATCH426354 <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 />Routt County Board of Commissioners <br />136 Sixth Street <br />AUTHORIZED REPRESENTATIVE <br />P.O. Bax 773840 <br />Steamboat Springs, CO 80477 <br />0 1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />sa YD: 14988031 BATCH426354 <br />