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VXI t (MMIUUIY Ty T)
<br />,A -CORD CERTIFICATE OF LIABILITY INSURANCE 11/02/2004
<br />TM
<br />PRODUCER (301) 733-2530 FAX (301) 791-1478 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />Kel l er-Stonebraker Insurance, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />1120 C Professional Court ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />PO Box 609
<br />Hagerstown, MD 21741-0609 INSURERS AFFORDING COVERAGE NAIC #
<br />INsuRED The Library Corporation INSURERA: Hartford Casualty Insurance Co 29424
<br />CARL Corporation, Inc., ETAL INSURERS: Hartford Fire Insurance Co. 19682
<br />Research Park INSURERc Twin City Fire Insurance Co. 29459
<br />Inwood, WV 25428 INSURER D:
<br />INSURER E:
<br />v THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDINI
<br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
<br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
<br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />DD'
<br />TYPE OF INSURANCE
<br />POLICY NUMBER
<br />POLICY EFFECTIVE
<br />POLICY EXPIRATION
<br />LIMITS
<br />GENERAL LIABILITY
<br />42UUNUA1381
<br />05/26/2004
<br />05/26/2005
<br />EACH OCCURRENCE
<br />$ 1,000,00
<br />X COMMERCIAL GENERAL LIABILITY
<br />DAMAGE TO RENTED
<br />$ 300,000
<br />CLAIMS MADE [�] OCCUR
<br />MED EXP (Any one person)
<br />$ 10,000
<br />PERSONAL BAOVINJURY
<br />$ 1,000,000
<br />A
<br />GENERAL AGGREGATE
<br />$ 3,000,000
<br />GENT AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMP/OP AGG
<br />$ 3,000,000
<br />POLICY PRO LOC
<br />JECT
<br />AUTOMOBILE
<br />LIABILITY
<br />ANY AUTO
<br />42UENUA1452
<br />05/26/2004
<br />OS/26/200S
<br />COMBINED SINGLE LIMIT
<br />(Ea a¢ident)
<br />$ 1,000,000
<br />X
<br />BODILY INJURY
<br />(Per person)
<br />$
<br />B
<br />ALL OWNED AUTOS
<br />SCHEDULED AUTOS
<br />HIRED AUTOS
<br />NON -OWNED AUTOS
<br />i
<br />_e C'��
<br />��9
<br />X
<br />BODILY INJURY
<br />(Per accident)
<br />$
<br />X
<br />PROPERTY DAMAGE
<br />(Per accident)
<br />$
<br />GARAGE LIABILITY
<br />AUTO ONLY - EA ACCIDENT
<br />$
<br />OTHERTHAN EA ACC
<br />AUTO ONLY: AGG
<br />$
<br />ANY AUTO
<br />$
<br />EXCESS/UMBRELUILIABILITY
<br />42RHUUA1427
<br />05/26/2004
<br />OS/26/200S
<br />EACH OCCURRENCE
<br />$ 3,000,06
<br />X OCCUR F-ICLAIMS MADE
<br />AGGREGATE
<br />$ 3,000,000
<br />$
<br />A
<br />$
<br />DEDUCTIBLE
<br />15
<br />X RETENTION $ 10,000
<br />WORKERS COMPENSATION AND
<br />42WBGU1360
<br />01/29/2004
<br />01/29/2005
<br />WCsrATIU- orH-
<br />C
<br />EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNEWEXECUTIVE
<br />OFFICEWMEMBER EXCLUDED?
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />S 1,000,000
<br />If yes, describe untler
<br />SPECIAL PROVISIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />B
<br />OTH
<br />roIressional Liability
<br />Claims Made-9/02/03
<br />OOTE022261904
<br />09/02/2004
<br />09/02/2005
<br />$2,000,000 Each Claim
<br />$2,000,000 Aggregate
<br />etro Date
<br />$25,000 Deductible
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
<br />ity of Santa Ana, Its Officers, employees, agents, volunteers and representatives are additional
<br />insured as respects the general liability policy
<br />0 day cancellation except notice of cancellation for non-payment of the premium will be 10 days.
<br />See attached Form H00001 - which is a part of the above referenced policy. Additional Insured status
<br />is described in Section II of the Insuring Agreement.
<br />r FC,TICIr ATP wni TIPP rANCF1 I ATIhN
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
<br />City of Santa Ana
<br />30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
<br />20 Civic Center Plaza M-30
<br />BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
<br />P.O. BOX 1998
<br />OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
<br />AUTHORIZED PRESENTATIVE
<br />Santa Ana, CA 92701
<br />ACORD 25 (2001108) v ©ACORD CORPORATION 1988
<br />
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