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Home My WebLink About273449 PONDER COMPANY INC - INSURANCE CERTIFICATE (6)�� ® DATE (MM/DD/YYYY) A Ilk�C" CERTIFICATE OF LIABILITY INSURANCE F8/28/2017 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 endorsements . CONTACT PRODUCER NAME: Debbie Aranda _ Arthur J. Gallagher Risk Management Services, Inc. PHONE g06-748-2015 FAX Not. 866 446 7371 110 North Marienfeld, Suite 330 E-MAI o, Ett)- -- __.-- Midland TX 79701 DORE 5 debbie_aranda@ajg.com INSURER(S) AFFORDING COVERAGE NAIL 1' INSURED PONDCOM-01 Ponder Company, Inc. 1545 W. Tufts Ave. Suite B Englewood CO 80110 INSURER A: Hanover Insurance COmpany INSURERB:Allmerica Financial Benefit Insurance CO INSURER c:Hanover American lnSUrance Company_ INSURER D: Texas Mutual Insurance Company INSURER E:Argonaut Insurance Company CCIVFRAr.FC r_FOTIFICATF n111RAQ1 D• R79204224 DG1nC1nn1 nu leeRGD. 2292 1840 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. III LTR TYPE OF INSURANCE ADDUISUBR 1 WV POLICY NUMBER POLICY EFF MMIDDNYYY POLICY EXP MIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY _J CLAIMS -MADE ❑ XOCCUR _ ZHDD02618801 8/31/2017 8/31/2018 EACH OCCURRENCE $1,000,000 -OAMAGE-TORENTM__ PREMISES Ea occurrence $100,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY �X PRE LOC OTHER: GENERAL AGGREGATE E2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY AWDD02619501 8/31/2017 8/31/2018 EaaccidernQ_ $1,000,000 X BODILY INJURY (Per person) $ 80DILY INJURY (Per accident) $ _ _ OPERT4"DAFitpG"� Per accident $ E C X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE UHDD02619101 8/31/2017 8/31/2018 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 DED I X I RETENTION $ 5,000 $ D I WORKERS COMPENSATION E AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA TSF0002002365 '8/31/2017 OSQ000051705 8/11/2017 8/3112018 8/11/1018 X R OTH- STATUTE ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) ADDITIONAL INSURED: Certificate Holder is an Additional Insured as respects to the General Liability & Automobile policy, Pursuant to the policy's terms, definitions, conditions and exclusions. Certificate Holder is included as Additional Insured on the General Liability & Automobile ppolicy, as per endorsement #421-0452, edition (12-14) CG2037, edition (04-13) CG2010, edition (04-13) & 461-0478, edition (12-12). WAIVER OF SUBROGATION: See Attached... CERTIFICATE HOLDER CANCELLATION City of Fort Collins PO Box 580 Fort Collins, CO CO 80522 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE �14��z 0 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: PONDCOM-01 LOC #: AC� � ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Arthur J. Gallagher Risk Management Services, Inc. NAMED INSURED Ponder Company, Inc. 1545 W. Tufts Ave. Suite B Englewood CO 80110 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: Ilisle G1R3aJ9L j THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Waiver of Subrogation applies to certificate holder, as respects to the General Liability & Automobile policy, pursuant to the policy's terms, definitions, conditions and exclusions. Waiver of Subrogation applies to certificate holder, as respects to the General Liability & Automobile policy, as per endorsement #CG2404, edition (05-09), 461-0500, edition (11-13) and Workers' Compensation policy, as per endorsement #420304B, edition (06-14). PRIMARY AND NON-CONTRIBUTING: The insurance provided in the General Liability policy is primary and any other insurance shall be excess only, and not contributing. NOTICE OF CANCELLATION: The Workers' Compensation, General Liability and Business Automobile policies include an endorsement providing that 30 days notice of cancellation or coverage change will be furnished to the certificate holder. Re: Northside Aztlan Community Center - Rabbit Room Aerobics Floor The general liability and auto policies include blanket additional insured endorsements (attached) that provide additional insured status to the certificate holder only when there is a written contract between the Named Insured and the certificate holder that requires such status. ACORD 101 (2008/01) V ZUU8 ACORD CUt<FUKA I IUN. An rlgnts reservea. The ACORD name and logo are registered marks of ACORD