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HomeMy WebLinkAbout143207 NEW BELGIUM BREWING COMPANY INC - INSURANCE CERTIFICATE (3)ACORD,, CERTIFICATE OF LIABILITY INSURANCE 12/1/2015 F DATE(MM/DD/YYYY) 1 2/12/2015 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 CONTACT NAME: 8110 E Union Avenue Suite 700 Denver CO 80237 PHONE A/C, No, Ext : A/C, No): E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # (303) 414-6000 INSURER A: 'The Hanover American Insurance Company 36064 INSURED New Belgium Brewing Company, Inc. INSURER B: The Hanover Insurance Com anv 22292 1350260 500 Linden Street Fort Collins CO 80524 INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES NEWBE01 CERTIFICATE NUMBER: 13354403 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. INSR LTR TYPE OF INSURANCE ADDL INSD SUER WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS-MADEEx I OCCUR Y N ZZ48945648-04 12/1/2014 12/1/2015 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence 1 OOO OOO MED EXP (Any oneperson) 5,000 PERSONAL & ADV INJURY $ 1000.000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY❑ JERK LOC OTHER GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO AUTOWNED SCHEDULED AUTOS NON -OWNED HIRED AUTOS X AUTOS N N AI{48902695-04 12/1/2014 12/1/2015 EOa BIaccEDtSINGLELIMIT $ 1,000000 X BODILY INJURY (Per person) $ XXXXXXX X BODILY INJURY (Per accident $ XXXXXXX PROPERTY DAMAGE Per accident $ XXXXXXXX Comp/Coll Ded. $ $500 B X UMBRELLA LIAB EXCESS LIAR )( OCCUR CLAIMS -MADE N N UH48903631-04 12/1/2014 12/1/2015 EACH OCCURRENCE $ 10000,000 AGGREGATE $ 10,000,000 DED RETENTION $ $ XXXXXXX E3 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? FN (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A N WM4A45199401 (ADS) W24A48960600 (CA, DE (�' MI) 12/1/2014 12/1/2014 12/1/2015 12/1/2015 PER OTH- X STATUTE E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE 1 ,000,000 E.L. DISEASE -POLICY LIMIT I A0,000 A Liquor Liability N N ZZ48945648-04 12/1/2014 12/1/2015 S1,000,000: Each Common Cause DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE — Event: Tour do Fat Fort Collins, Date and Times: Thursday, September 3, 2015 from 5pm to I Opm — Friday, September 4, 2015 from lam to I Opm — Saturday, September 5, 2015 from 6am to 1 1:59pm — Sunday, September 6, 2015 from lam to 12pm. The City of Fort Collins. its officers, agents, employees and volunteers are included as Additional Insured as respects General Liability if required by written contract. 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. 13354403 AUTHORIZED REPRESENTATIVE City of Fort Collins Attn: Risk Management PO Box 580 Fort Collins, CO 80522-0580 C j ACORD 25 (2014/01) ©1 B812014 ACORD CORPO ATION. All rights reserved Thu Arr1pr1 n- and Innn aru rcnictcrcrl m 16-c of Ar:r1Ar1