2019-07-30_GENERAL DOCUMENTS - C1982056

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Page 1 of 1 A` DATE(MM/2101 Y) CERTIFICATE OF LIABILITY INSURANCE D„229 � F 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 have ADDITIONAL INSURED provisions or 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 CONTACT Willis Towers Watson Certificate Center NAME: Willis of Tennessee, Inc. - -- -- - c/o 26 Century Blvd IAIC,No Exit:PHONE 1-877-945-7378 A'C' 1-888-4677-2378-2378 E-MAIL certificates@willis.com Box 305191 ADDRESS: c_ @ Nashville, TN 372305191 USA INSURERS)AFFORDING COVERAGE NAIC N INSURERA: ACE American Insurance Company 22667 INSURED INSURERS: Consortium 9984 D1074 Peabody Energy Corporation -— 701 Market Street INSURER C_ Suite 700 INSURER D: St. Louis, MO 631011826 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:W12091205 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. INSR', TYPE OF INSURANCE AODL,SUBk POLICY EFF POLK:Y EXP ` LIMITS LTR POLICY NUMBER MMIDD/YYY MM/DD/YYYY X COMMERCIAL GENERAL LIABILITYEACH OCCURRENCE $ 2,000,000 CLAIMS-MADE X OCCUR PREMISES(Ea occuirencel-_ $ 2,000,000 A MED EXP(Any oneperson) $ Y HDOG71 I 08/01/2019108/01/20201 2,000,000 F PERSONAL&ADV INJURY $ r _GEN'L AGGREGATE LIMIT APPLIES PER a. J r GENERAL AGGREGATE $ 2,000,000 PRO X POLICY`JECT LOG a r-” PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER $ AUTOMOBILE LIABILITY `, COMBINED SINGLE LIMIT $ Ea accident ANY AUTO ,.. "C J BODILY INJURY(Per person) $ OWNED SCHEDULED AF4�` AUTOS ONLY _ AUTOS �1 ® r BODILY INJURY(Per accident) $ HIRED I NON-OWNED L °'` , � PROPERTY DAMAGE —�$ AUTOS ONLY I AUTOS ONLY (Per accident) i $ B X UMBRELLA LIAB I X OCCUR I'� ; EACH OCCURRENCE $ 3,000,000 EXCESS UAB CLAIMS-MADE B080Evrv. V 08/01/2019108/01/2020, AGGREGATE }$ 3,000,000 DED X RETENTIONS 25,000 $ PER OTH- WORKERS COMPENSATION STATUTE ER AND EMPLOYERS'LIABILITY Y/N n - -- ANYPROPRIETORIPARTNER)EXECUTIVE L. EL EACH ACCIDENT !$ OFFICER/MEMBEREXCLUDED? MIA \`\ (Mandatory in NH) J�+� f�ON E.L.DISEASE-EA EMPLOYEE!$ If yes,describe under �Cl.r` E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DN`MUIN 1N�N�SND I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached It more space is required) RE: Twentymile Coal, 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 Twentymile Coal, LLC including the use of explosives. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Colorado Division of Reclamation, Defining and Safety AUTHORIZED REPRESENTATIVE 1313 Sherman Street, Room 215 Denver, CO 80203 +x'1 "-- i `"q ®1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD sse ID: 18287849 BATCH: 1293074 2 of 4 271