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Home My WebLink About143207 NEW BELGIUM BREWING COMPANY - INSURANCE CERTIFICATEACORD. CERTIFICATE OF LIABILITY INSURANCE 12n/zola DA6/2/2014 YV) 6/2/2014 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 endorsement(s). PRODUCER Lockton Companies 8110 E Union Avenue .Suite 700 Denver CO 80237 (303) 414 0 CT AME: I FAX C No): A/C No Ed : MC, E-MAIL IN R RDIN C C wSURER A: The Hanover American Insurance Company 36064 INSURED New Belgium Brewing Company, Inc. 1066637 500 Linden Street Fort Collins CO 80524 INSURER B: The Hanover Insurance Company 22292 INSURERC: Pinnacol Assurance Company 41190 1 INSURER D; Zurich American Insurance Company 16535 INSURER INSURER F' rnVCDAres NPIVRFO1 CFRTIFICATF NIIMRFR- 12191124 REVISION NUMBER: XXXXXXX 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. INSRR TYPE OF INSURANCE ADDL SUER POLICY NUMBER PMMIDDIYYYY OLICY EFF 12/1/2013 MM/UUY UP 12/1/2014 LIMITS A X. COMMERCIAL GENERAL LIABILITY CLAIMS -MADE E OCCUR Y N ZZ48945648-03 EACH OCCURRENCE S 1000000 DAMAGE PREMISE TO RENTED a une.xe 1,000,000 MED UP (Any oneperson) 10,000 PERSONAL S ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY jECT LOC OTHER GENERAL AGGREGATE B2000000 PRODUCTS - COMPIOP AGO $ 2,000,000 $ B AUTOMOBILE LIABILITY X ANY AUTO X ALTUS�ED AUTOppSULED X HIRED AUTOS X AUTOSY�ED N N AH48902695-03 12/1/2013 12/1/2014 E..,d.ntSINGLELIMIT $ 1000000 BODILY INJURY (Per pawn) S XXXXXXX BODILY INJURY (Par accdent $ XXXXXXX PROPERTYDAMAGE S XXXXXXX• Comp/Coll Ded. $ 500 B X UMBRELLALIAB EXCESS LIAB X OCCUR CLAIMS -MADE N N UH48903631-03 12/12013 12/1/2014 EACH OCCURRENCE S5000000 AGGREGATE S 5,000,000 DED I I RETENTION $ S XXXXXXX D C WORK ERSCOMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNEFE ECIITIVE Y/N OFFICERIMEMBER E CWDED? (MandRery in NH) It unaer DESCRIPTION NOFOPERATIONStelda NIA N WC4632485-04-/`AOS) 4D2Q2%61CG GIYLYj 6/12014 6/I/2D14 6/I/201$ 6/1/201$ ER TH-1 X STATUTE E.L. EACH ACCIDENT f 500000 E.L. DISEASE- EA EMPLOYEE Is 500,000 EL DISEASE -POLICY LIMIT 500000 A Llqum Lmlohly N N ZZ48945648-03 12/li2u13 12/1/2014 SIp00,000: Each Common Cause DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Tour de Fat Fort Collins, Civic Center Park, August 29th, 2013 - August 31st, 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. CERTIFICATE HOLDER GANGELLATION 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 Management P.O. Box 580 Fort Collins CO 80522 ACORD 25 (2014/01) ©1 ORPOKATION. All rights reserved Th. Annon ...on. and inns . wr.IcfurnH ..,k. of ACnRn