2019-07-30_GENERAL DOCUMENTS - M1978315 (2)

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I'/ 'K Page 1 of 1 " J la �L7� CERTIFICATE OF LIABILITY INSURANCE °07/22/2019) 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(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 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 P.O. Box 305191 ADDRL SS: certificates@willis.com Nashville, TN 372305191 USA INSURER(S)AFFORDING COVERAGE NAIC INSURERA: ACE American Insurance Company 22667 INSURED Peabody Energy Corporation INSURER B 701 Market Street INSURER C: _ Suite 700 INSURER D: St. Louis, NO 631011826 INSURER E: INSUR R F: COVERAGES CERTIFICATE NUMBER:W12091204 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 IADDL'SUBR; POLICY EFF POLICY EXP LTR POLICY NUMBER MMIDDIYYY MMIDDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE r OCCUR AMA I PREMISES(Ea_occurrencej i MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ PRO- j -- - - - -^ - POLICY JECT LOC PRODUCTS-COMP/OP AGG $ OTHER- $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2 000,000 �Ea acciden ,t) __ X ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED Y ISAH25302199 08/01/2019�08/01/2020 BODILY INJURY(Per accident);$ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY LPer accident) I I I $ UMBRELLA LIAB OCCUR EACHOCCURRENCE $ EXCESS LIAB CLAIMS-MADE r�"� i AGGREGATE '$ DED RETENTION$ Cry v VVV' $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN Q 19 ' STATUTE ER ANYPROPRIETORrPARTNEFVEXECUTIVE 3� 3O (,O E L EACH ACCIDENT $ OFFICER�MEMBEREXCLUDED? ,NIA (Mandatory In NH) �p, ON E.L.DISEASE-EA EMPLOYEEI$ It yes.describe under DESCRIPTION OF OPERATIONS below ECU E L DISEASE-POLICY LIMIT $ � I I DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached it more space Is required) Re: Peabody Sage Creek Mining LLC - Red Rock Pit State Permit: I1-78-315 County Permit: PP2011-018 It is agreed that Routt County Board of Commissioners, 136 6th Street, P.O. Box 773749, Steamboat Springs, Offiad as an Additional Insured as respects to Auto Liability where required contract or agreement. JUL 3 U 2019 CERTIFICATE HOLDER CANCELLATION vvmwq� ON SHOULD ANY OF THE ABOVE DESCRIBED POUCIES 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 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 BATCH: 1293074 304 271