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GENERAL44444
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GENERAL44444
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Entry Properties
Last modified
8/24/2016 8:13:14 PM
Creation date
11/23/2007 1:02:07 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1980003
IBM Index Class Name
General Documents
Doc Date
10/5/2005
Doc Name
Certificate of Liability Insurance
To
DMG
Permit Index Doc Type
Insurance
Media Type
D
Archive
No
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ACORD <br />CERTIFICATE OF LIABILITY INSURANCE U1~ <br />n <br />Page 1 of 2 1Q/ <br />2QQ5 <br />PRODUCER 877-945-7378 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Willis North America, lnc. - Repioaal Cert center HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />26 century Blvfl. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />P. O. Box 305191 <br />Nashville, TN 372305191 INSURERS AFFORDING COVERAGE NAIC# <br />INSURED peabody Energy Corporation INSURER A: ACE American Iasu <br />ol~any <br />22667-001 <br />701 Market Street <br />MO 63101-1876 <br />St <br />Louis <br />INSURER B: <br />. <br />, <br /> INSURER C: <br /> INSURER D: <br /> INSURER E: <br />COVERAGES Glvisl~,. <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD MDICATEQiNOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR DD' TypE OFINSURANCE POLICY NUMBER POLICY EFFECTIVE POLICVM Pp ADON LIMBS <br />A GENERAL LIABILITY HDOG21713661 IQ <br />/I/ZQQS I/zQQ6 <br />I <br />Q/ EACH OCCURRENCE $ Z QQQ QQQ <br /> X __ <br />COMMERC4ALGENERAL LIABILITY _ _ _ <br />_ <br />-' PFEMISES EzEONxTUrence $ SO OOO <br /> CLAIMS MADE ~ OCCUR MEO EXP (Any one person) $ 5 QQQ <br /> PERSONAL&ADV INJURY $ 1 OOO OOO <br /> GENERAL AGGREGATE $ 4 OOO QQQ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 4 OOO OOO <br /> POLICY PRO- LOC <br />A AUT OMOBILE LIABILITY ISAHO8O21892 lO/1/ZOOS 1O/1/ZOO6 COMBINED SINGLE LIMIT <br /> <br />(Eaamiden0 $ 2000, 000 <br /> X ANVAUTO <br /> ALLOWNEDAUTOS <br />BODILY INJURY <br /> <br />SCHEDULED AUTOS <br />(Per person) $ <br /> HIRED AUTOS <br />BODILY INJURY <br />$ <br /> NON~OW NED AUTOS (Per accitlen0 <br /> PROPERTY DAMAGE <br /> $ <br /> (Peraaitlent) <br /> GARAGE LIABILITY AUTOONLV-EA ACCIDENT $ <br /> ANV AUTO OTHERTHAN EA ACC $ <br /> AUTOONLV: AGG $ <br /> EXCESS LIABILITY EACH OCCURRENCE $ <br /> OCCUR ~ CLAIMS MADE AGGREGATE $ <br /> <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br />--" WORKERS COMPENSATION~ANO'-` _ -`---~-^' -- -- -- ---- -- --^ STATU- "- OTH= '-` - ---- -- - <br /> ' ARV LIMIT <br /> EMPLOYERS <br />LIABILITY <br /> ANY PROPRIETORrPARTNER/EXECUTIVE E. L. EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? <br />EL DISEASE-EA EMPLOYEE <br />$ <br /> If yes. describe antler <br /> SPECIAL PROVISIONS below E. L. DISEASE-POLICY LIMIT $ <br /> OTHER <br />DESCRIPTON OF OPERATONS/LOCATIONSNEHICLESIE%CLUSIONB AODEO BY ENOORSEMENT/SPECIAL PROVISIONS <br />Named Insured: Hayden Gulch Terminal <br />Covers operations at Hayden Gulch Mine including damage from surface coal mine operations, the use <br />of explosive and damages to water wells. <br />~o-~ <br />van:Iru.Ja I e <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THEE%PIRADON <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O DAYS WRITTEN <br />NODCE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />COlOradO Department NatLLial ReSOUrCeB IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />Diviaioa of Minerals and Geology <br />ROOM 715 REPRESENTATIVES. <br />1313 Sharman Street AUTHORIZED REPRESENTADV <br />Denver, co eoao3-zz73 ~j <br />ACORD 25 (2001/08) Co11:1417593 R'p1:417434 Cert:6285373 ®ACORD CORPORATION 1988 <br />
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