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ACORL. CERTIFICATE OF LIABILITY INSURANCE
<br />M
<br />DATE(MM/DD/YYYY)
<br />05/22/2012
<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 be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />Insurance Brokers of MD - Hagerstown
<br />13126 Pennsylvania Ave.
<br />PO Box 3767
<br />Hagerstown, MD 21742
<br />NAME: Nancy Stottl emyer
<br />HONE
<br />Ext: 301.790.0652 FAX,No):301.790.0962
<br />VV
<br />ADDRIESS:
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />INSURERA: One Beacon America Ins. Co.
<br />20621
<br />INSURED The Library Corporation
<br />Carl Corporation, Tech -Logic Corporation
<br />1 Research Park
<br />Inwood, WV 25428
<br />INSURER B: One Beacon
<br />18458
<br />INSURER C:
<br />INSURERD:
<br />INSURER E :
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: 2012-2013 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 />INSR
<br />WVD
<br />POLICY NUMBER
<br />(MM/DD/YYYY)
<br />(MM/DDfYYYY)
<br />LIMITS
<br />GENERAL LIABILITY
<br />711011330-0003
<br />05/26/2012
<br />05/26/2013
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />J CLAIMS -MADE 1XI OCCUR
<br />PREMISES (Ea occurrence)
<br />$ 1,000,00(
<br />VIED EXP (Any one person)
<br />$ 10,00(
<br />PERSONAL & ADV INJURY
<br />$ 1,000,00(
<br />A
<br />GENERAL AGGREGATE
<br />$ 2,000,00(
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMP/OP AGG
<br />$ 2,000,00(
<br />POLICY X PRO-
<br />JECT LOC
<br />$
<br />AUTOMOBILE
<br />LIABILITY
<br />711011330-000
<br />05/26/2012
<br />05/26/2013
<br />(Ea accident)
<br />$ 1,000,000
<br />X
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />A
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />NON -OWNED
<br />HIRED AUTOS %� AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />X
<br />(Per accident)
<br />$
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />711011330-000
<br />05/26/2012
<br />05/26/2013
<br />EACH OCCURRENCE
<br />$ 6,000,000
<br />A
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />AGGREGATE
<br />$ 6,000,000
<br />DED I X I RETENI 0
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />OFFICER/MEMBERANY /EXCLUDED? ECU]Y/N
<br />�N/AE.L.
<br />in NH)
<br />yes, describe under
<br />DESCRIPTION OF OPERATIONS belo
<br />40602873
<br />05/26/2012
<br />05/26/2013
<br />X TORY LIMITS ER
<br />EACH ACCIDENT
<br />$ 1,OOO,OO(Mandatory
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,0OIt
<br />E.L. DISEASE - POLICY LIMIT
<br />1 $ 1,000,000
<br />Professional Liability-
<br />711011330-000
<br />05/26/2012
<br />05/26/2013
<br />$5,000,000 Each Wrongful Act
<br />q
<br />laims-Made-9/2/2003
<br />Retro
<br />$5,000,000 Aggregate
<br />$25,000 Deductible
<br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />ity of Santa Ana, Its Officers, Employees, Agents, Volunteers and representatives are additional
<br />insured as respects the general liability policy if required by written contract CG2010 (07/04)
<br />and CG2037 (07/04) attached. Coverage is primary and non- contributory per form VCG207 (0709)
<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 />City of Santa Ana
<br />20 Civic Center Plaza M-30 AUTHORIZED REPRESENTATIVE 7 �,�_A'161—�
<br />P.O. Box 1988
<br />Santa Ana, CA 92701 Nancv Stottlemver/NLS
<br />ACORD 25 (2010/05)
<br />The ACORD name and logo are registered marks of ACORD
<br />All riahts reserved.
<br />;� ,ya
<br />
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