2009-07-31_GENERAL DOCUMENTS - C1980007

• Permit No: C1980007
• IBM Index Class Name: GENERAL DOCUMENTS
• Doc Date: 7/31/2009
• Doc Name: Certificate of Liability Insurance
• From: ARCH Coal Inc
• To: DRMS
• Permit Index Doc Type: Insurance
• Email Name: TAK
• Media Type: D
• Archive: No

ACORD' CERTIFICATE OF LIABILITY INSURANCE DATE
M/DD/YYYY)
L? 0
7/30/2009
07/30/
PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION
Marsh USA Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
701 Market Street, Suite 1100 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
St. Louis, MO 63101-1830
Attn: stlouis
certr
u
t
h ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
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@mars
.com
001950--Reg-09-10 Y INSURERS AFFORDING COVERAGE NAIC #
INSURED Mountain Coal Company, L.L.C. FCE`' F1D
?VG INSURER A: National Union Fire Ins Co Pittsburgh PA 19445
P.O. Box 591 INSURER B:
1 Mile East of Somerset - Hw
133
y
Somerset, CO 81434 1 3 ?OQ? INSURER C:

atiOn' INSURER D:
`dciam IN
R

)rvla"' V _a CafetV SU
ER E:
COVERAGES Mining 611- - 11
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
NS
LTR ADD'
INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION
LIMITS
DATE (MM/DD/YYYY) DATE (MMIDD/YWY)

A GENERAL LIABILITY GL093-61-11 07/31/2009 07/31/2010 EACH OCCURRENCE 300 000

X
COMMERCIAL GENERAL LIABILITY
*A $500,000 general aggregate DAMAGE TO RENTED
PREM SES Ea occurrence)
$ 50,000
CLAIMS MADE ? OCCUR per location IVIED EXP (Any one person) $ 5,000
X Explosion Liability (XGLJ) PERSONAL &ADV INJURY $ 300
000
,
GENERAL AGGREGATE $ 500
000
GE NERAL AGGREGATE
LIMIT APPLIES PER ,
PRO-
PRODUCTS - COMP/OP AG 500,000
POLICY JECT LOC
AU TOMOBILE LIABILITY
COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident)

ALL OWNED AUTOS BODILY INJURY $
SCHEDULED AUTOS (Per person)
HIRED AUTOS
BODILY INJURY $
NON-OWNED AUTOS (Per accident)
?• PROPERTY DAMAGE
'MIA Sol (Per accident) $
GARAGE LIABILITY Sy ^,?„
w AUTO ONLY - EA ACCIDENT $
ANY AUTO 0
11:
w 80m 1Sr 2013 OTHER THAN EA ACC $
?
p
W^??w #V74
I,II11il 177 AUTO ONLY: $
AGG
EXCESS /UMBRELLA LIABILITY
- EACH OCCURRENCE $
OCCUR F
1 CLAIMS MADE AGGREGATE $
DEDUCTIBLE $
$
RETENTION $
WORKER COMPENSATION AND WC STATU- OTH-
EMPLOYE RS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N .L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED?
N
L. DISEASE - EA EMPLOYE
$
Mandatory in NH) If yes, describe under
PECIAL PROVISIONS below
L. DISEASE -POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Coverage is included for surface coal mining and reclamation operations including the use of explosives. C-80-007 West Elk Mine
CERTIFICATE HOLDER CHI-002370223-22 CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
Colorado Dept. Of Natural Resources EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL 0=K,)W3P MAIL
Division of Reclamation, Mining & Safety
1313 Sherman Street, Room 215 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,

Denver, CO 80203 DtIXd?IrO(?4D(aC)tiCDOC?dC?Q1NC Cp4il?i!( C?1tif0?f(X10)dJRKJeS)(X
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