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2013-06-17_GENERAL DOCUMENTS - C1981044
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2013-06-17_GENERAL DOCUMENTS - C1981044
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Entry Properties
Last modified
8/24/2016 5:21:29 PM
Creation date
6/17/2013 9:18:36 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981044
IBM Index Class Name
General Documents
Doc Date
6/17/2013
Doc Name
Certificate of Liability Insurance
From
Jerry Nettleton
To
DRMS
Permit Index Doc Type
Insurance
Email Name
ZTT
DIH
Media Type
D
Archive
No
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AGENCY CUSTOMER ID: <br />LOC #: <br />A` °R°® ADDITIONAL REMARKS SCHEDULE Page-2—of 2 <br />AGENCY <br />NAMED INSURED <br />Peabody Energy Corporation and Subsidiaries <br />Willis of Tennessee, Inc. <br />Attn: Robert Fenley <br />701 Market Street <br />Suite 700 <br />POLICY NUMBER <br />See First Page <br />St. Louis, MO 63101 -1826 <br />CARRIER <br />NAIC CODE <br />EFFECTIVEDATE: See First Page <br />ACE American Insurance Company <br />22667 -001 <br />ADDITIONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE <br />The County Governments and /or County Commissioners of the Counties identified above are included <br />as Additional Insured Parties re: General Liability, but only in respect to their interest in the <br />operations of the Named Insured, and only for such terms and limits which are the lesser of the <br />policies hereon or the written requirements between the Named Insured and the Certificate Holder. <br />ACORD 101 (2008101) Coll : 3905349 Tpl :1544835 Cert:18784785 © 2008 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />
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