2019-07-30_GENERAL DOCUMENTS - M1978315

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JI 1 X (��3 I r/ Page 1 of 1 ~ .4C'C7/eLJ►�'� CERTIFICATE OF LIABILITY INSURANCE °07/222//2019' 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 NAME: Willis of Tennessee, Inc. PHONE 1-877-945-7378 FAX 1-888-467-2378 c/o 26 Century Blvd A/C No: E-MADDRSS: A P.O. Box 305191 IL certificates@willis.com_ Nashville, TN 372305191 USA INSURER(S)AFFORDING COVERAGE NAICM INSURER A: ACE American Insurance Company 22667 INSURED INSURER B: Peabody Energy Corporation — 701 Market Street INSURER C____ _ Suite 700 INSURER D: St. Louis, MO 631011826 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:W12091206 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 TYPE OF INSURANCE 'ADDL SUER, POLICY EFF POLICY EXP ' LIMTS LTR POLICY NUMBER MMIDWYYYY MMIDDIYYYY X COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE $ 2,000,000 CLAIMS-MADE _X ' OCCUR PREMISES LEs occurrence,_t_$__.- _- 2,000,000 A MED EXP(Any one person) J$ Y HD0071574003 08/01/2019i08/01/2020; PERSONAL&ADVINJURY $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER r 2,000,000 - - - - q�!NIERAL AGGREGATE X POLICY PR0 L JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 _ OTHER, $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ LEa accident) ANY AUTO j BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED i PROPERTY DAMAGE $ AUTOS ONLY I_ AUTOS ONLY (Pei accident)- ! I$ UMBRFILALIA6 OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE �O�O AGGREGATE $ I , N ; DED RETENTION$ $ WORKERS COMPENSATION `, ER I - AND EMPLOYERS'LIABILITY Y/N `'`$�©``�F R � � I El EACH ACCIDENT ER $ ANYPROPRIETOR/PARTNER/EXECUTIVE f1 V N OFFICE PUMEMBEREXCLUDED? N I A V` FI��NA ID In NH) M,N �E L DISEASE-EA EMPLOYEE $ It ns,describe under DESCRIPTION OF OPERATIONS below E L.DISEASE-POLICY LIMIT $ i � I DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached If more space is required) Re: Peabody Sage Creek Mining, 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 Peabody Sage Creek Mining, LLC including the use of explosives. 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 ttj Denver, Co 80203 01988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD SR ID: 18287549 sarcH: 1293074 4 of 4 271