2019-08-01_GENERAL DOCUMENTS - C1982056

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Page 1 of 1 AC 1 T � DATE(MMIDDIYYYY) IJRO CERTIFICATE OF LIABILITY INSURANCE F07/22/2D19 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. c/o 26 Century Blvd PHONE Ext): 1-877-945-7378 AIC No: 1-866-467-2378 P.O. Box 305191 ADDRLSS: certificatesewillia.com Nashville, TN 372305191 USA INSURER($ AFFORDING COVERAGE NAIC# INSURERA: ACE American Insurance Company 22667 INSURED INSURERS: 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:W12091207 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.$UBW POLICY EFF . POLICY EXP LIMITS LTR POLICY NUMBER MM0D/YYY I MM/DD/YY X COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE $ 2,000,000 DAMAGE TO RENTEU-- CLAIMS-MADE X , OCCURPREMISES Ea occurrence $ 2,000,000 -r --- - A MED EXP(Any one person) $ Y HDOG71574003 08/01/201908/01/20202,000,000 PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 X l POLICY PRO- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 JECT OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000 X ANY AUTO BODILY INJURY(Per person) $ A OWNED 7-1 SCHEDULED ISAH25302199 08/01/2019108/01/2020 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY i (,Per acadenlZ $ UMBRELLAOCCUR EACHOCCURRENCE $ EXCESSSAB CLAIMS-MADE RECEIVED AGGREGATE ._ . _- .- -._$ — DED RETENTION$ $ WORKERS COMPENSATION 2019 STATUTE ERH ,AND EMPLOYERS'LIABILITY AUG 0 - - ANYPROPRIETOR,PARTNERIEXECUTIVE YIN EL EACH ACCIDENT $ OFFICERWMEMBEREXCLUDED' NIA '(Mandatory In NH) i E.L.DISEASE-EA EMPLOYEE,$ II yes,describe wWer ^'^',!nF RECL"TjON - DESCRIPTION OF OPERATIONS belowE L DISEASE-POLICY LIMIT $ � l DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re: Foidel Creek (Mine, C1982-056 Covers operations including damage from surface coal mine operations, the use of explosives and damage to water wells. It is agreed that Colorado Division of Reclamation, Mining and Safety is included as an Additional Insured as respects to General Liability, but solely in regards to work being performed by or on behalf of the Named Insured. 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 313 Sherman Street, Room 215 Denver, CO 80203 m 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD SR ID: 18287549 BATCH: 1293074 2 of 2 4696