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HomeMy WebLinkAbout143207 NEW BELGIUM BREWING COMPANY INC - INSURANCE CERTIFICATEACORD,. CERTIFICATE OF LIABILITY INSURANCEbn/2o1a DATE ll/26/201326/2013 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 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 endomement(s). PRODUCER Lockton Companies, LLC Denver 8110 E Union Avenue Suite 700 Denver CO 80237 (303)414-6000 CONTACT NANR AI No EXt : -A No WC, E-MAIL ADDRESS' IN R R AFFOR01NO COVERAGENAICk INSURER A: The Hanover American Insurance Company 36064 INSURED New Belgium Brewing Company, Inc. 1066637 500 Linden Street 1�320� Fort Collins CO 80524 INSURER B : The Hanover Insurance Company 22292 INSURERC: Pinnacol Assurance Com an 41190 INSURER 1 Zurich American Insurance CompanyCompmy 16535 INSURER F: rnvoowr_vc AIG111QT7Ai CERT¢Irarc MnM9E!R: 194Q1 I?d REVISION NUMRFR- XXXXXXX vTHIS 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 R TYPE OF INSURANCE ADDL Y SUBR POLICY NUMBER POLICY EFF 12/1/2013 PO ICY EXP 12/1/2014 LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX1 OCCUR N ZZ48945648-03 EACH OCCURRENCE 1000000 T Ea occurrence PREMIS 1,000.000 _ MED EXP (My oneperson) 10,000 PERSONAL $ ADV INJURY $ 1 000 000 GENERAL AGGREGATE 000 $ 1000.000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- -7poLscYF7JECT PRODUCTS-COMP/OP AGG $ 2000000 $ B AUTOMOBILE LIABILITY ANY AUTO ALL OOSWNED rHEESULED HIRED AUTOS X AAUTOS ED N N AH48902695-03 12/1/2013 12/1/2014 Ea acc,.ntSINGLELIMIT $ 1000000 X BODILY INJURY (Per person) $ XXXXXXX X BODILY INJURY (Per accident $ XXXXXXX X Per aERe DAMAGE $ XXXXXXX Comp/Coll Ded. $ 500 B X UMBRELLA LIAB EXCESS LIAR X OCCUR CLAIMS -MADE N N UH48903631.03 12/1/2013 12/1/2014 EACH OCCURRENCE $ 5000000 AGGREGATE $ 5 000 000 DIED I I RETENTION $ $ XXXXXXX C WORKERS COMPENSATION AND EMPLOYERS'LIABILITY y/N ANY PROPRIETORIPARTNER/EXECLmffE OFFICER/MEMSER EXCLUDEDr a (ANndMOry in NH) DESCRIPTION OF OPERATIONS tel. NIA N WC4632485-03-I(`AOS) 4D2D276(COGIVI'Y] 6/1/2013 6/1/2013 6/I/2014 6/1/2014 WC STATU- TRH X T RY LIMIT E.L. EACH ACCIDENT $ 500000 E.L. DISEASE - EA EMPLOYEE S 500000 E.L. DISEASE -POLICY LIMIT 500000 A Liquor Liability N N I ZZ48945648-03 12/1/2013 12/1/2014 $ 1,000,000: Each Common Cause DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES /(Attach ACORD 101, Additional Remarks Schedule, If more space is required) RE: Tour de Fat Fort Collins, Civic Center Park, August 29th, 2013 - August 31 st, 2013. The City of Fort Collins, its officers, agents, employees and volunteers are listed as additional insureds with respect to General Liability if or when required by written contract or agreement. UEK I IFIUA I E HULULK L.nrva.c��n r Ivry SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 12391124 AUTHORIZED REPRESENTATIVE City of Fort Collins Risk Maneggement P.O. Box 40 Fort Collins CO 80522 ar/e Vl ACORD 25 (2010106) ©ORPOKATION. All rights reserved Th. Arnwn r ro-< of ar non