2012-11-06_REVISION - C1992081 - Laserfiche WebLink

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TH,S INDICATED CERTIFICATE E INSR ITR A IS ?:CLUSIONS GENERAL X 0 E 1 TO CERTIFY NOTWITHSTANDING MAY AND CONDITIONS TYPE OF INSURANCE LIABILITY COt'!.1LRCIAL 1 CLAIMS-MADEf 1 A lSGREGATEI 501 ICY II THAT BE ISSUED GENERAL X I M T A P F ,u-c,1 THE POLICIES ANY REQUIREMENT, OR MAY PERTAIN OF SUCH LIABILITY (OCCUR I IES 553 I LOt, OF INSURANCE POLICIES ADD'Li NSRr, THE SUB F} wvnll LISTED BELOW HAVE BEEN TERM OR CONDITION OF INSURANCE AFFORDED LIMITS SHOWN MAY HAVE BEEN POLICY NUMBER HDOG2701351A ISSUED TO ANY CONTRACT BY THE POLICIES REDUCED BY POLICYEFF (MHJDSAA 11/1/2012 THE INSURED OR OTHER DOCUMENT DESCRIBED PAID CLAIMS POLICYEXP I,hniyyyy 11/1/2013 NAMED ABOVE FOR THE WITH RESPECT HEREIN IS SUBJECT TO LIMITS EACH OCCURRENCE DA A MAGL 1 PEN rE ence) E MIS S ORE N EED MEDEXP (Any ar,epei,00) PERSONAL B ADV INJURY GENERAL AGGREGATE PRODUCTS- COMPIOPAGG POLICY PERIOD TO WHICH THIS ALL THE TERMS, S 5,000,000 5 1,90_,C100 5 5,000 $ 5, 000, 000 S 6,000,000 5 6,000,000 5 A AUTOMOBILE X LIABILITY ANY AJTO ALL OWNED AUTOS HIRED AUTOS ISC !AUTOS l NON -OANCU !AUTOS 1 1SAH0871194A 11/1/2012 11/1/2013 CO0BINEOSINGLELIMIT (E'1 acudenl BODILY INJURY(Per perso'3 BODILY INJURY(Per accident) PROPERTY DAMAGE (Per scodert) $ 5 ,_ 000,000 5 5 S UMBRELLALIAS EXCESS LIAB L f OCCUR CLAIMS - MADE FAO -1 OCCURRENCE 5 AGGREGATE - - S - - $ r DED : i RETENTIONS WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YJN ANY PROPRIETOR/PARTNER /EXECUTIVE, -_f OFFICER,M =MDER EXCLUJED� { Mandatorym NH) "yes d -;r,reugd DESCRI'T ION 05 O -EFA TI?'JSbeIce NIA I WC STATU- IOTH- - - SORE LIMITB - I EA E EACH ACCIDENT 5 E DISEASE- EA EMPLOYEE 5 L L DISEASE - POLICY LIMIT $ 1 DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (At ach Acord 101, Adddooal RemarFS Schedule, if more spacers required) Named Insured: Hayden Gulch Terminal, Inc. Covers operations at Hayden Gulch Loadoul Facility including damage from surface coal, etc., Permit C -92 -081. Colorado Department of Natural Resources Division of Reclamation, Mining and Safety Room 215 1313 Sherman Street Denver, CO 80203 -2273 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS AUTHORIZED REPRESENTATIVE _ - -_ )4LL4) A 9RD CERTIFICATE OF LIABILITY INSURANCE �r 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 pollcy(ies)must 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 INSURED COVERAGES CERTIFICATE HOLDER ACORD 25 (2010/05) Willis of Tennessee, Inc. c/o 26 Century Blvd. P.O. Box 305191 Nashville, TN 37230 -5191 Peabody Energy Corporation and Subsidiaries Attn: Robert Fenlcy 701 Market Street Suite 700 St. Louis, MO 63101 -1826 CERTIFICATE NUMBER: 18784897 CONTACT NAME tt FAX - A2C.NO FAT; 877 945 - 7378 - (A /c. NO; E ADDRESS -__ certificatesewillis.com INSUREP(S)AFF033OG COVERAGE INSURERA ACE American Insurance Company INSURER B IL >JREF: INSURER C INSURER E INSURER F CANCELLATION The ACORD name and logo are registered marks of ACORD Page 1 of 1 REVISION NUMBER. DATE (r.1RUDD'YYYY) 10/29/2012 888 - 467 -2378 NAIC 22667 -001 Coll:3905349 Tpl:1 544829 Cert:18784897 © 1988-2010 ACORD CORPORATION. All rights reserved.