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AGENCY CUSTOMER ID: <br /> LOC#: <br /> A`oR" ADDITIONAL REMARKS SCHEDULE Page 2 of 2 <br /> AGENCY NAMED INSURED <br /> Willis Towers Watson Southeast, Inc. Peabody Energy Corporation and Subsidiaries <br /> 701 Market Street <br /> POLICY NUMBER suite 700 <br /> See Page 1 St. Louis, MO 631011826 <br /> CARRIER NAIC CODE <br /> See Page 1 See Page 1 EFFECTIVEDATE: See Page 1 <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 6 Safety and the State Board of <br /> Land Commissioners are included as Blanket Additional Insured with respect to General Liability, where required by <br /> contract or agreement. General Liability limits, as noted in the Certificate, include each covered operation/property, <br /> and are restricted only as designated (i.e. : Each Occurrence or Any One Person ) . County Governments and/or County <br /> Commissioners are identified as an Blanket Additional Insured parties with respect to the General Liability coverage, <br /> however this coverage is limited to their interest(s)in the operations and activities of the Named Insured, and only <br /> for such terms and limits which are the lesser of the policies hereon, or the written requirements and/or agreements <br /> between the Named Insured and the Certificate Holder(s) . <br /> ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br /> SR ID: 19901111 BATCH: 1758394 CERT: W17339552 <br />