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2019-07-30_GENERAL DOCUMENTS - C1994082 (3)
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2019-07-30_GENERAL DOCUMENTS - C1994082 (3)
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Last modified
8/1/2019 10:49:57 AM
Creation date
8/1/2019 6:53:49 AM
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Template:
DRMS Permit Index
Permit No
C1994082
IBM Index Class Name
General Documents
Doc Date
7/30/2019
Doc Name
Certificate of Insurance
To
DRMS
Permit Index Doc Type
Insurance
Media Type
D
Archive
No
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_ Page 1 of 1 <br /> AATE(MMIDD/YYY <br /> `COROCERTIFICATE OF LIABILITY INSURANCE FD07/22/2019Y) <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 CONTACT Willis Towers Watson Certificate Center <br /> NAME: <br /> Willis of Tennessee, Inc. - -- - _l ' <br /> c/o 26 Century Blvd tAt Exit:PHONE 1-877-945-7378 _ C No• 1-888-467-2378 <br /> P.O. Box 305191 ADDRESS: certificates@willis-COM <br /> Nashville, TN 372305191 USA INSURER(S)AFFORDING COVERAGE _ NAIC <br /> INSURER A: ACE American Insurance Company 22667 <br /> Me <br /> INSURED ""' <br /> INSURER B: <br /> Peabody Snargy Corporation and Subsidiari <br /> 701 Market Street INSURER C: _ <br /> Suite 700 INSURER D: <br /> St. Louis, MO 631011826 ';}� 701 <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERT ` 1201 REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF I� 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 /> IL7p ADDLSUBR, POLICY EFF POLICY EXP <br /> TYPE OF INSURANCE <br /> POLICY NUMBER MM/DDIYYY MMIDDlYYYY LIMITS <br /> X COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE $ 2,000,000 <br /> DAMAGE TO RENTED <br /> CLAIMS-MADE _X OCCUR PREMISES(Ea occurrence) ,-_ $- 2,000,000 <br /> 7► MED EXP(Any one person) $ " <br /> HDOG71574003 08/01/2019108/01/2020I PERSONAL&ADV INJURY $ 2,000,000 <br /> GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 <br /> X I POLICY PRO- <br /> JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 <br /> OTHER i$ <br /> AUTOMOBILE LIABILITY <br /> �E�a�aBcdeDI <br /> X SINGLE LIMIT $ 2,000,000 <br /> - i - - <br /> AU <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> A OWNED -7 SCHEDULED ISAR25302199 08/01/2019I08/01 2020 BODILY INJURY(Per accident).$ <br /> AUTOS ONLY AUTOS _ <br /> HIRED NON-OWNED PROPERTY DAMAGE <br /> AUTOS ONLY �� AUTOS ONLY r(.Per accident) i$ <br /> $ <br /> UMBRELLALIAB OCCUR EACH OCCURRENCE i$ <br /> EXCESS LIAB CLAIMS-MADE ;AGGREGATE $ <br /> DED RETENTION$ S <br /> WORKERS COMPENSATION PER j STATUTE R <br /> AND EMPLOYERS'LIABILITY YIN <br /> ANYPROPRIETOR/PARTNER/EXECUTIVEF-1E L EACH ACCIDENT $ <br /> OFFICERIMEMBEREXCLUDED1 N/A <br /> (Mandatory In NH) j E.L.DISEASE-EA EMPLOYEE$ <br /> II as.describe under <br /> DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ <br /> I <br /> i <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) <br /> Named Insured include: Seneca Property, LLC <br /> Covers operations at Yoast Mine including damage form Surface Coal !dine, Yoast Mine operations, the use of explosives <br /> and damage to water wells. <br /> CERTIFICATE HOLDER CANCELLATION <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 /> Colorado Division of Reclamation, Mining 6 Safety AUTHORIZED REPRESENTATIVE <br /> 1313 Sherman Street, Room 215 r <br /> Denver, CO 80203 'ff <br /> ®1988-2016 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br /> sR VD: 18287549 BATcH: 1293074 <br /> 3 of 3 270 <br />
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