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2013-07-30_GENERAL DOCUMENTS - C1981044
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2013-07-30_GENERAL DOCUMENTS - C1981044
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Last modified
8/24/2016 5:23:03 PM
Creation date
7/30/2013 8:37:59 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981044
IBM Index Class Name
General Documents
Doc Date
7/30/2013
Doc Name
Certificate of Liability Insurance (Emailed)
From
Jerry Nettleton
To
DRMS
Permit Index Doc Type
Insurance
Email Name
JDM
ZTT
DIH
Media Type
D
Archive
No
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AGENCY CUSTOMER ID: <br />LOC #: <br />ADDITIONAL REMARKS SCHEDULE <br />Paged 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 />Covered operations /properties include: Mesa Gravel Pit - Peabody Sage Creek Mining, LLC <br />(M -82 -036); Red Rock Gravel Pit - Peabody Sage Creek Mining, LLC (M -78 -315); Hayden Gulch Loadout - <br />Hayden Gulch Terminal, LLC (C -92 -081); Big Elk Property - Cottonwood Land Holdings, LLC; Williams <br />Fork Mines - Moffat Count Mining, LLC (C -81 -044); Foidel Creek Mine - Twentym'le Coal, LLC <br />(C -82 -056); Peabody Sage Creek Mine - Sage Creek Coal Company, LLC (C -09 -087); Vista Ridge and <br />Associated Real Estate Holdings - TwentXmile Coal, LLC; Shoshone Mine - Shoshone Coal, LLC (477); <br />Related Exploration and Development Activities. <br />Covered entities include Peabody Energy Corporation and all associated subsidiaries operating in <br />the noted coverage areas. In addition, those state and county governments with regulatory <br />authority over the covered operations /properties are included as additional insured parties with <br />respect to General Liability, where required by contract or agreement. General liability limits, <br />as noted in the Certificate, apply to each covered operation /property, and are restricted only as <br />designated (i.e.: "Each Occurrence" or "Any One Person "). <br />County Governments and /or County Commissioners are identified as Additional Insured parties with <br />respect to the General Liability coverage, however this coverage is limited to their interest(s) in <br />the operations and activities of the Named Insured, and only for such terms and limits which are <br />the lesser of the policies hereon, or the written requirements and /or agreements between the Named <br />Insured and the Certificate Holder(s). <br />ACORD 101 (2008/01) Coll:4168706 Tpl:1544835 Cert: 20177800 © 2008 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />
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