2012-11-15_GENERAL DOCUMENTS - C2009087

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i�CCA � CERTIFICATE LIABILITY ' Page 1 of 1 DATE(MWDD /YYYY) 10/29/2012 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 policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions ofthe 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 CONTACT Willis of Tennessee, Inc. c/o 26 Century Blvd. P.O. Box 305191 Nashville, Tx 37230 -5191 PHONE 877- 945 -7378 FAX ggg_467 -2378 E -MAIL s certificates @willis.com y HDOG2701351A INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: ACE American Insurance Company 22667 -001 DAMAGE TO RENTED PREMISES Eaoccurence INSURED Peabody Energy Corporation INSURERS: X COMMERCIAL GENERAL LIABILITY INSURER C: Attn: Robert Fenley 701 Market Street Suite 700 INSURERD: CLAIMS -MADE OCCUR INSURER E: St. Louis, MO 63101 -1826 INSURER F: MED EXP (Any one person) COVERAGES CERTIFICATE NUMBER: 18784920 REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN TR TYPE OF INSURANCE DD' SU8 POLICY NUMBER POLICYEFF POLICYEXP LIMITS A GENERAL LIABILITY y HDOG2701351A 11/1/2012 11/1/2013 EACHOCCURRENCE $ 5,0 0 000 DAMAGE TO RENTED PREMISES Eaoccurence $ 100,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR MED EXP (Any one person) $ 5,000 PERSONAL& ADV INJURY $ 5,000,000 GENERAL AGGREGATE $ 6,000,000 GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OPAGG $ 6,000,000 $ POLICY n PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT accident) $ BODILY INJURY(Per person) $ ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident ( ) $ _ HIREDAUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Peraccident) $ $ UMBRELLAUAB OCCUR EACHOCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I RETENTION $ $ WORKERS COMPENSATION 1 WCST - ANDEMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? D IMandatory inNH) tf yes, describe under E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach Acord 101, Additonal Remarks Schedule, if more space is required) Re: Peabody Sage Creek Mining, LLC It is agreed that Colorado Division of Reclamation, Mining and Safety is included as an Additional Insured as respects to General Liability where required by contract or agreement. Covers operations at Peabody Sage Creek Mining, LLC including the use of explosives. L,r-M I Ir[%,A I t nUL.UtK L;ANGtLLA 1 IUN 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 Colorado Division of Reclamation, Mining and Safety 1313 Sherman Street, Room 215 / ,J Denver, CO 80203 it " -_ ) , (/' Coll e 3 905349 Tnl e 1 544824 Cary n 1 R7 R4920 n 19RR -2n1n ACnRn roPPnRATinKI ®II rinhtc racprvprl ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD