2019-07-30_GENERAL DOCUMENTS - C1981044

Home Browse Search

Page 1 of 1 A4 O_ CERTIFICATE OF LIABILITY INSURANCE FDATE(MMD2019 ) �,- o7/zz/2o19 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 CONTACT Willis Towers Watson Certificate Center _ Willis of Tennessee, inc. NAME:PHONE 1-877-945-7378 FAXCNo 1-888-467-2378 c/o 26 Century Blvd A E-MAIL ertificates P.O. Box 305191 ADDRESS: c_ @willis.com Nashville, TN 372305191 OSA _ INSURER(S)AFFORDING COVERAGE NAIC N INSURERA: 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: COVERAGES CERTIFICATE NUMBER:W12091200 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. LTR TYPE OF INSURANCE AODL SUBRi POLICY EFF POLICY EXP POLICY NUMBER MM/DD/YYYY MMO DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 _ CLAIMS-MADE X OCCUR2,000,000 PREM)SES(Ea occurrence) --- --- A MED EXP(Any one person) $ HDOG71574003 08/01/2019 i(38/01/2020� PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 X POLICY, PRO- ;JECT ; LOC PRODUCTS-COMP+OP AGG 1$ 2,000,000 OTHER- AUTOMOBILE LIABILITYCOMBINED SINGLE LIMIT ! $ 2,000,000 I �Ea accident)_ __- X ANY AUTO BODILY INJURY(Per person) $ A OWNED AUTOSSCHEDULED ISAM25302199 08/01/2019 08/01/2020' BODILYINJURY(Peraecdenpi$ AUTOS ONLY L AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Peraccident) _ $- ! 1$ -� UMBRELLA LIAB L� OCCUR EACHOCCURRENCE is EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ; ER ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ E L EACH ACCIDENT $ OFFICERIMEMBEREXCLUDED') NIA (Mandatory In NH) E.L•DISEASE EA EMPLOYEE!$ It yes,describe under `�— DESCRIPTION OF OPERATIONS below El DISEASE-POLICY LIMIT s I j DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached it more space is required) Moffat County Mining, LLC Including Permit C-81-044. RECEIVED JUL 30 2019 CERTIFICATE HOLDER CANCELLATION DIVISI ��F��( SHOULD ANY OF THE 1i18E'tY 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 Denver,15CO 80203 ®1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD SR rD: 18287549 aarce: 1293074 2 of 2 266