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ACORd CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MwpDNYYY)
<br />05/0112020
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AM END, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terns and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />NAME ONT Nancy Stottlemyer
<br />Insurance Brokers of MD - Hagerstown
<br />vHONE (301)790-0652 cNoi: (301)790-0982
<br />13126 Pennsylvania Ave.
<br />ADOREss: nancy.stot9emyer@ibmofmd.com
<br />PO Box 3767
<br />INSURE S AFFORDING COVERAGE
<br />NAIC9
<br />Hagerstown MD 21742
<br />INSURER A: Twin City Fire Ins. Co.
<br />29459
<br />INSURED
<br />INSURER B. Hartford A&I Co.
<br />22357
<br />The Library Corporation
<br />INSURER C : Hanford Fire Ins. Co.
<br />19682
<br />Carl Corporation and Tech -Logic Corporation
<br />INSURER D
<br />1 Research Park
<br />INSURER E
<br />Inwood WV 25428
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 2020-2021 REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />LTR
<br />TYPE OF INSURANCE
<br />POLICY NUMBER
<br />MMIDDNYYYPCLIGYEFT
<br />MMADD/YYYY CYEXP
<br />LIMITS
<br />COMMERCIALGENERALLMBILRY
<br />EACHOCCURRENCE
<br />S 1,000,000
<br />CLAIMS -RUDE ® OCCUR
<br />/
<br />✓ /PREMISES
<br />fEd rt
<br />S 1,000,000
<br />MEDEXP An brie repo
<br />S 10,000
<br />J
<br />PERSONAL&ADVINJURY
<br />s 1,000,000
<br />A
<br />Y
<br />30SBAVK5698
<br />05/08/2020
<br />051=021
<br />GENLAGGREGATE
<br />LIMITAPPLIES PER
<br />GENERALAGGREGATE
<br />S 2,000.000
<br />POLICY ® JEGT ® LOC
<br />PRODUCTS
<br />$ 2,000,000
<br />$
<br />OTHER
<br />AUTOMOBILE
<br />LIABILITY
<br />(E,, ert) IoNLE LIMIT
<br />S 1,000,000
<br />✓
<br />BODILY INJURY(Perpmeon)
<br />S
<br />ANYAUTO
<br />B
<br />OVMED SCHEMED
<br />AUTOS ONLY AUTOS
<br />30UECFP3134
<br />05/0812020
<br />05/08/2021
<br />BODILY INJURv Peraxmenn
<br />S
<br />HIRED NON -OWNED
<br />PROPERTYMMAGE
<br />p r
<br />S
<br />AUTOS ONLY AUTOS ONLY
<br />S
<br />UMBRELLA WB
<br />OCCUR
<br />FAGREGAT RflENCE
<br />6-000,000
<br />AGGREGATE
<br />$ 6,000,000
<br />A
<br />Excess une
<br />CI -AIMS -MADE
<br />305BAVK5698
<br />05/08/2020
<br />05/08l2021
<br />DED I >Q RETENTION S 10,000
<br />S
<br />WORKERS COMPENSATION V,PER
<br />OTH-
<br />ANDEMPLOYERS' LIABILITY YIN
<br />T
<br />E.L. EACH AccIDENT
<br />1,000,000
<br />C
<br />OFFICERIMEMBER EXC UDEED?EPROPRIETORIPARTNERVEXWTIVE a..
<br />NIA
<br />30WECAD2KBN
<br />05/08/2020
<br />05/0812021
<br />EL. DISEASE =EA EMPLOYEE
<br />S 1,000,000
<br />IMen4Mryb
<br />andNHI
<br />DESCRI
<br />E1. DISEABE- POLICY LIMIT
<br />g 1,000,000
<br />TIONunder
<br />DESCRIPTION OF OPERATIONS below
<br />E&O,Information Risk, Media Liability &
<br />Aggregate Limit
<br />$5.000,000
<br />C
<br />First Parry Ezpense
<br />30TE0336969-20-Claims-Made
<br />05/08/2020
<br />05108/2021
<br />Each Wrongful Act
<br />$5,D00,000
<br />Retention
<br />S 25,000
<br />DESCRIPTON OF OPERATIONS I LOCATONS / VEHICLES IADORo 1a1, A4eNonM Remerks SCM1WYIe, mry W eMpM1ed If more epxa la rpulretll
<br />City of Santa Ana, Its Officers, employees, agents, volunteers and representatives are addillonal Insured as Indicated, and coverage is primary, ✓
<br />noncontributory when required by written contract Cer86cate of Insurance shall provide thirty (30) day prior written notice of cancellation. J
<br />REVIEWED & APPROVED
<br />By R15k MANAGEMENT DIVISION
<br />CERTIFICATE HOLDER U AV ofln Innn CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City Of Santa Ana ANCf1E ACEVEdo
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Risk Management Division
<br />AUTHORIZED REPRESENTATIVE
<br />20 Civic Center Plaza 4th Fl
<br />Santa Ana CA 92702
<br />�,eLiAeryA
<br />01988.2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
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