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2019-07-30_GENERAL DOCUMENTS - M1982036
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2019-07-30_GENERAL DOCUMENTS - M1982036
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Last modified
12/18/2024 8:04:03 AM
Creation date
8/2/2019 12:30:26 PM
Metadata
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Template:
DRMS Permit Index
Permit No
M1982036
IBM Index Class Name
GENERAL DOCUMENTS
Doc Date
7/30/2019
Doc Name
Certificate of Insurance
From
Willie of Tennessee/Peabody Energy
To
DRMS
Email Name
PSH
Media Type
D
Archive
No
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AGENCY CUSTOMER ID: <br /> Iw LOC 0: <br /> ACORO ADDITIONAL REMARKS SCHEDULE Page 2 Of 2 <br /> AGENCY NAMED INSURED <br /> Millis of Tennessee, Inc. Peabody energy Corporation and Subsidiaries <br /> 701 Market Street <br /> POLICY NUMBER Suite 700 <br /> See Pape 1 St. Louis, NO 631011826 <br /> CARRIER "IC CODE <br /> See Page 1 See Page 1 I EFFECTIVE DATE:See Page l <br /> ADDITIONAL REMARKS <br /> THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br /> FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance <br /> (C-82-056); Sage Creek Mine - Peabody Sage Creek Mining, LLC (C-09-087) . <br /> Covered entities include Peabody Energy Corporation and all associated subsidiaries operating in the noted coverage <br /> areas. <br /> Colorado Department of Natural Resources, Colorado Division of Reclamation, Mining i Safety and the State Board of <br /> Land Coarmissioners are included as Additional Insured with respect to General Liability, where required by contract or <br /> agreement. General Liability limits, as noted in the Certificate, include each covered operation/property, and are <br /> restricted only as designated (i.e.: Each Occurrence or Any One Person ). County Governments and/or County <br /> Commissioners are identified as an Additional Insured parties with respect to the General Liability coverage, however <br /> this coverage is limited to their interest(s)in the operations and activities of the Named Insured, and only for such <br /> terms and limits which are the lesser of the policies hereon, or the written requirements and/or agreements between <br /> the Named Insured and the Certificate Holder(s). <br /> ACORD 101 (20W01) ®2006 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br /> SR ID: 18287549 BATCH: 1293074 CERT: W12091208 <br />
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