2018-08-08_GENERAL DOCUMENTS - C1981044

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_ Page 1 of 1 IY AC40RL> CERTIFICATE OF LIABILITY INSURANCE °07/2620 8' 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 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 CONTACT NAME: Willis of Tennessee, Inc. �� PHONE FAX A/ No E 1-677-945-7378 AIC No: 1-888-967-2378 c/o 26 Century Blvd ® E-MAIL P-O. Box 305191 ��//��►►.. ADDRESS: certificates@willis.com Nashville, TN 372305191 USA ��V INSURERS AFFORDING COVERAGE NAIL# ni-\N INS RERA: ACE American Insurance Company 22667 INSURED ER B Peabody Energy Corporation and Subsidiaries p J''J 701 Market Street 1 SURER C: Suite 700 `OF� S9 v INSURER D: St. Louis, NO 631011826 O\zs\O`\�V\�r lJ INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:W6990347 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MMIDD MM/DD X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 DAMAGE-TO CLAIMS-MADE �OCCUR PREMISES(Ea occurrence) $ 2,000,000 A MED EXP(Any one person) $ HDOG 71209003 08/01/2018 08/01/2019 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- ❑PRO JECT ❑LOC PRODUCTS-COMP/OP AGG $ 2,000,000 X P OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ A OWNED ONLY L SCHEDULED ISAH 25268398 08/01/2018 08/01/2019 BODILY INJURY(Per accident) $ AUTOSHIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ E L EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED� N/A (Mandatory in NH) E L DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below L I E L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Moffat County Mining, LLC Including Permit C-81-044. CERTIFICATE HOLDER CANCELLATION 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 Division of Reclamation Mining and Safety AUTHORIZED REPRESENTATIVE 1313 Sherman Street Room 215 %/� � ".yt q Denver, CO 80203 - ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD SR In 16501781 BATCH: 803455