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HomeMy WebLinkAboutA5527- ANHEUSER-BUSCH COMPANIES INS. ONLYC) �s- '� �R�® CERTIFICATE OF LIABILITY INSURANCE ATE06/ /O22YYY 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 Aon Risk Services Central, Inc. St. Louis NO Office REC2NL'D CONTACT NPHONE AME: MC (AC. W. EXO; (Bfi6) 283-7122 Ra; (800) 363-0105 E-MAIL ADDRESS: 42ZO Duncan Avenue Suite 401 JUL y 20�� St Louis NO 63110 USA 1 INSURER(S) AFFORDING COVERAGE NAIC N INSURED of the CityClerk INSURERA: ACE American Insurance Company 22667 Anheuser-Office Companies, LLC Divisions Cos Divisions & Subsidiaries Its Corporate Risk Management &insurance (202-5) One Busch Place INSURER B: ACE Fire Underwriters Insurance Co. 20702 INsuRERc: Indemnity Insurance co of North America 43575 INSURER 0: INSURER E: St. LOUIS, NO 63118-1852 USA INSURER F: 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. Limits shown are as requested LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER LIMITS X COMMERCIAL GENERAL LIABILITY HDOG EACHOCCURRENCE $5,000,000 CLAIMS -MADE X❑OCCUR PREMISES Ea currence $5,000,000 MEDEXP(Anyons Person) $10,000 PERSONAL a ADV INJURY $5,000,000 GE'LAGGREGATE LIAR APPLIES PER: GENERALAGGREGATE 5,000,000 % O. POLICY ❑JET �LOC PRODUCTS - COMPIOP AGO $5,000,000 OTHER. Lpuor UAbiOry Lim xncluded A AUTOMOBILE LIABILITY ISA H25571630 07/01/202207/01/2023 COMBINED SINGLE LIMITMa accigeml i2, 000, 000 BODILY INJURY( Per Parson) % ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED AUTOS NON-0WNED ONLY AUTOS ONLY BODILY INJURY (Per ecciaeril PROPERTY DAMAGE Per xcidem UMORELLALIAS OCCUR EACH OCCURRENCE EXCESS LIAR CLU S-MADE AGGREGATE DED I RETENTION C B WORKERSCOMPENSATXNIAND EMPLOYERS' LIABILITY /N ANY PROPRIETOR I PARTNER I EXECUTIVE OFFICER0IEMBER EXCLUDED? H (Wnem.y In NM 0 yes. deecbbe antler DESCRIPTION OF OPERATIONS below NIA WLRC All Other States SCFC68921053 WI 07/01/2022 07/01/2023 X PER STATUTE E.L. EACH ACCIDE NT $51000,000 E.C. DISEASE -EA EMPLOYEE $5,000,000 E.L. DISEASE -POLICY LIMIT $5,000, OOO DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addibe"I Remarks Schedule, may be MMched N more space Is required) The certificate holder is included as an additional insured in accordance with endorsement CG 2026 (07/04) attached to the above referenced policy.. 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. rL: City of Palm Springs AUTHORIZED REPRESENTATIVE itl-YtsB Department of Parks and Recreation Scott Mi kesell P.C. t P.O. BOX 2743 Palm Springs CA 92263 USA atevirD �slt�cG era. ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD `w AGENCY CUSTOMER ID: li6778 ' LOC #: R ADDITIONAL REMARKS SCHEDULE Page _ of _ » AGENCY _ - Aon Risk services central, Inc. NAMED INSURED Anheuser-Busch Companies, LLC. " - -POLICY NUMBER' See Certificate Number: 570094249926 CARRIER See Certificate Aumber: 570094249926 'NAIC CODE EFFECTIVE DATE: ACORD 25 .FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER - ... INSURER INSURER—_" ADDITIONAL POLICIES If a policy,below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. IN50. LTR TYPEOFINSURANCE ADDL INSD, BUBB WVD POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YYVY) .POLICY EXPIRATION DATE (hN1610/YYY1) LIMITS WORKERS COMPENSATION A - N/A WLRC68921Q16 CA, MA, AZ 07/01/2022 07/01/2023 ACORD 101 (2008101) ® 2008 ACORD CORPORATION. All riDMs The ACORD name and logo are registered marks of ACORD 11 l 5 POLICY NUMBER: HDO G72961049 Endorsement Number: 2 COMMERCIAL GENERAL LIABILITY CG 20 26 12 19 THIS'ENDORSEMENT CHANGES THE POLICY. PLEASEREAD IT CAREFULLY. ADDITIONAL INSURED.- DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE -- -Name-OfAdditional-insured-Person(s) Or Organization(s)rAnyperson-or organization'whom yotfhave agreed to include as an additional insured under a written contract, provided such contract was executed prior to the date of loss. I Information required to comolete this Schedule. if not shown above. will be shown in the Declarations. I A. Section II —'Who Is An, Insured is amended to include, as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and, advertising injury" caused, in whole or in •part, by your acts' or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations;, or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If.coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement • to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following, is added to Sectiomlll — Limits Of Insurance: If coverage provided to the additional insured is, required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contractor agreement; or, 2. Available under the applicable limits of insurance; whichever is less. This 'endorsement shall riot increase_ the applicable limits of insurance. CG 20 2612 19 ©Insurance Services Office,, Inc., 2018 Page 1 of 1