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AGENCY <br />Marsh USA Inc <br />NAMED INSURED <br />Mountain Coal Company, L.L.C. <br />P 0 Box 591 <br />1 Mile East of Somerset - Hwy 133 <br />Somerset, CO 81434 <br />POLICY NUMBER <br />CARRIER <br />NAIC CODE <br />EFFECTIVE DATE <br />ACORN <br />ADDITIONAL REMARKS <br />ACORD 101 (2008/01) <br />AGENCY CUSTOMER ID: 001950 <br />LOC #: St. Louis <br />ADDITIONAL REMARKS SCHEDULE <br />Page 2 of 2 <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance <br />This policy is amended as follows. <br />In the event that the Insurer cancels this policy for any reason other than non - payment of premium, and <br />1 the cancellation effective date is pnor to this policy's expiration date, <br />2 the First Named Insured is under an existing contractual obligation to notify a certficate(s) holder(s) when this policy is canceled (hereinafter, the "Certificate Holder(s)") and has provided the Insurer, either directly or <br />through it's broker of record, either <br />(a) the name of the entity shown on the certificate, a contact name at such entity and the U S Postal Service mailing address of each such entity, or <br />(b) the email address of a contact at each such entity, and <br />3 prior to the effective date of cancellation, the First Named Insured confirms to the Insurer, either directly or through its broker of record, that the persons or organizations set forth in the Schedule above, as well as their <br />respective addresses listed, should continue to be a part of the Schedule and, if not, the names of the persons or organizations that should be deleted, <br />the Insurer will provide advice of cancellation (the "Advice ") to each such Certificate Holder(s) confirmed by the First Named Insured in writing to be correctly a part of the Schedule within 30 days after the First Named <br />Insured confirms the accuracy of the Schedule above with the Insurer, provided, however, that if a specific number of days is not stated above, then the Advice will be provided to such Certificate Holder(s) as soon as <br />reasonably practicable after the First Named Insured confirms the accuracy of the Schedule above with the Insurer. <br />Proof of the Insurer emailing the Advice, using the information provided and subsequently confirmed by the First Named Insured in writing, will serve as proof that the Insurer has fully satisfied its obligations under this <br />endorsement. <br />This endorsement does not affect, in any way, coverage provided under this policy or the cancellation of this policy or the effective date thereof, nor shall this endorsement invest any nghts in any entity not insured under <br />this policy <br />The following Definitions apply to this endorsement. <br />1 First Named Insured means the Named Insured shown on the Declarations Page of this policy <br />2. Insurer means the insurance company shown in the header on the Declarations Page of this policy. <br />All other terms, conditions and exclusions shall remain the same <br />© 2008 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />