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Digitally signed by Francine R.
<br />Francine R. Villareal Villareal
<br />/
<br />ACCOR " CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DD/YYYY)
<br />8/4/2021
<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 AMEND, 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 terms 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 />Arthur J. Gallagher Risk Management Services, Inc.
<br />1050 Crown Pointe Pkwy, Suite 600
<br />GA 30338
<br />CONTACT
<br />NAME: Stephanie Clesla
<br />PHONE FAX
<br />A/C No Ext : 678-393-5277 A/C, No):
<br />E-MAtlanta
<br />ADDRESS: stephanie_ciesla@ajg.com
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />INSURERA: Valley Forge Insurance Company
<br />20508
<br />INSURED LYRA143-01
<br />LYRASIS DBA BiblioLabs LLC
<br />1438 West Peachtree St. NW Suite 150
<br />INSURERB: Continental Insurance Company
<br />35289
<br />INSURERC: American Casualty Company of Reading, PA
<br />20427
<br />INSURERD: Steadfast Insurance Company
<br />26387
<br />Atlanta , GA 30309
<br />INSURER E :
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: 1574301279 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 />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSD
<br />SUBR
<br />WVD
<br />POLICYNUMBER
<br />POLICY EFF
<br />MM/DD
<br />POLICY EXP
<br />MM/DD
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />Y
<br />6017210152
<br />4/16/2021
<br />4/16/2022
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />CLAIMS -MADE OCCUR
<br />DAMAGES(RENTED
<br />PREMISES Ea occurrence)
<br />ccurrence)$
<br />1,000,000
<br />MED EXP (Any one person)
<br />$ 15,000
<br />PERSONAL &ADV INJURY
<br />$ 1,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />POLICY ❑ PRO
<br />JECT LOC
<br />PRODUCTS - COMP/OP AGG
<br />$ 2,000,000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />6017210149
<br />4/16/2021
<br />4/16/2022
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />X
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />B
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />6017210121
<br />4/16/2021
<br />4/16/2022
<br />EACH OCCURRENCE
<br />$ 3,000,000
<br />AGGREGATE
<br />$ 3,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED X RETENTION $ 1 n nnn
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />6017210135
<br />4/16/2021
<br />4/16/2022
<br />X PER OTH-
<br />STATUTEI ER
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />OFFICER/MEMBER EXCLUDED? FN]
<br />N/A
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />D
<br />Cyber, Media & Technology
<br />EOC 0156547-03
<br />4/16/2021
<br />4/16/2022
<br />Each Claim
<br />$2,000,000
<br />Liability
<br />Aggregate
<br />$2,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />City of Santa Ana,officers, agents, employee& volunteers are Additional Insured as respects General Liability pursuant to and subject to the policy's terms,
<br />definitions, conditions and exclusions. The insurance provided in the General Liability policy is primary and any other insurance shall be excess only, and not
<br />contributing.
<br />CERTIFICATE HOLDER CANCELLATION
<br />City of Santa Ana
<br />Risk Management
<br />Division 4TH FLOOR
<br />20 Civic Center Plaza
<br />Santa Ana CA 92702
<br />ACORD 25 (2016103)
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE /
<br />IZAManagzmentDMsian
<br />oRaN
<br />z REVIEWED & APPROVED SY:
<br />1.
<br />@ 1988-2015 ACORD C °I G` f,�; y,e "441d
<br />The ACORD name and logo are registered marks of ACORD Risk Management Analyst
<br />
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