2009-11-03_GENERAL DOCUMENTS - C1982056

• Permit No: C1982056
• IBM Index Class Name: GENERAL DOCUMENTS
• Doc Date: 11/3/2009
• Doc Name: Certificate of Insurance
• Permit Index Doc Type: Insurance
• Email Name: JHB
• Media Type: D
• Archive: No

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CERTIFICATE OF LIABILITY INSURANCE page 1 of 2 10%30/20 '
PRODUCER 877-945-7378 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
HOLDER
Willis of Tennessee, Inc.
26 century Blvd. .
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P. 0. Box 305191
Nashville, TN 37230-5191 INSURERS AFFORDING COVERAGE NAIC#
INSURED Peabody Energy Corporation and Subsidiaries INSURERA:National Union Fire Insurance Company 19445-011
Attn: Ryan Brown
INSURER B:
701 Market Street
Suite 700 INSURERC:
St. Louis, MO 63101-1826
INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
ANY REQUIREMENT
,
THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
MAY PERTAIN
,
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR DD'
NSR
TYPE OF INSURANCE
POLICY NUMBER POLICYEFFECTIVE
DATE(MMIDDfYYYY) POLICY EXPIRATION
DATE (MM1DDfYYYY1 LIMITS
---
A X GENERAL LIABILITY GL4807243 11/1/2009 11/1/2010 EACHOCCURRENCE $ 2,000,000
X COMMERCIAL GENERAL LIABILITY PREMISES EaEoccccurence $ 100,000
CLAIMS MADE F7xOCCUR MED EXP (Any one person) $ 5 000

PERSONAL& ADV INJURY $ 2,000,000
GENERALAGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000
POLICY JECOT- LOC
A AU TOMOBILE LIABILITY CA4806729 11/1/2009 11/1/2010 COMBINED SINGLE LIMIT $ 2
000
000
X ANY AUTO (Ea accident) ,
,

ALL OWNED AUTOS BODILY INJURY
$
SCHEDULED AUTOS
(Per person)
HIRED AUTOS BODILY INJURY
$
NON-OWNEDAUTOS (Per accident)

PROPERTYDAMAGE

(Per accident) $
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $

ANYAUTO OTHERTHAN EAACC $
AUTOONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACHOCCURRENCE $
OCCUR FICLAIMS MADE AGGREGATE $

DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION WC STATU- OTH-
TORY LIMITS ER
AND EMPLOYERS' LIABILITY
Y
a
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
E.L. DISEASE - EA EMPLOYEE
$
Ifyesdescdbeunder

IAL es OVISIDNSbelow
SPE6d

E. L. DISEASE-POLICY LIMIT

$
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Re: Foidel Creek Mine, C1982-056
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.
C--ERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL 1HX.X MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFt(AQDtX361EI1f YffJ tTAbVX&L
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P.O. BOX 1094 A TAORIZE' RES A E REP
Craig, CO 81626
ACORD 25 (2009/01) Coll:2850022 Tp1:1004416 Cert:1$37893 ©1988-2009ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD