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ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br />TM 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 />UUNIACT
<br />NAME: Nancy Stottl emyer
<br />FAX
<br />PHONE EXt, 301.790.0652 (A/C,No):301.790.0962
<br />ADDRESS:
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC#
<br />INSURER A: 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 'y ,€�/� r S
<br />INSURERB: One Beacon
<br />18458
<br />INSURERC:
<br />INSURER D :
<br />INSURER E :
<br />INSURER F :
<br />r.T.��I TCcTIII lyrd`r:1,llld,l:l4:iW411IVAU'd119 VATJJ,9rel,I.17La1:14:
<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/DD/YYYY)
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE T OCCUR
<br />711011330-0003
<br />05/26/2012
<br />05/26/2013
<br />EACH OCCURRENCE
<br />$ 1,000,00(
<br />PREMISES Ea occurrence
<br />$ 1,000,00(
<br />MED EXP (Any one person)
<br />$ 10,00(
<br />PERSONAL & ADV INJURY
<br />$ 1,000,00(
<br />GENERAL AGGREGATE
<br />$ 2,000,00(
<br />GEML AGGREGATE LIMIT APPLIES PER:
<br />POLICY X PRO LOG
<br />JECT
<br />PRODUCTS - COMP/OP AGG
<br />$ 2,000,000
<br />$
<br />A
<br />AUTOMOBILE LIABILITY
<br />X ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />X HIRED AUTOS X NON -OWNED
<br />AUTOS
<br />711011330-0003
<br />05/26/2012
<br />05/26/2013
<br />Ea accident)
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />BODILY INJURY (Per accident)
<br />$
<br />Per accident)
<br />$
<br />A
<br />X
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />711011330-0003
<br />05/26/2012
<br />05/26/2013
<br />EACH OCCURRENCE
<br />$ 6,000,000
<br />AGGREGATE
<br />$ 6,000,000
<br />DED I X RETENTION $ 0
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />OFFICER/MEMBER EXCLUDED? ANY ECUTIV�
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />N / A
<br />40602973
<br />05/26/2012
<br />05/26/2013
<br />X I Two RY LAMITS ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />E.L. DISEASE - POLICY LIMIT
<br />I $ 1,000,000
<br />A
<br />Professional Liability-
<br />�laims-Made-9/2/2003
<br />etro
<br />711011330-000
<br />05/26/2012
<br />05/26/2013
<br />$5,000,000 Each Wrongful Act
<br />$5,000,000 Aggregate
<br />$25,000 Deductible
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / 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 (07104)
<br />and CG2037 (07/04) attached. Coverage is primary and non- contributory per form VCG207 (0709)
<br />r rrwr r e= nvr_Ur_n (/ —_-c -.. l.A1Vl,tLLA I IVIV -
<br />I 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
<br />P.O. Box 1988
<br />Santa Ana, CA 92701
<br />ACORD 25 (2010/05)
<br />AUTHORIZED REPRESENTATIVE
<br />Nancy Stottl
<br />© 1988-2010 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />II slIZ
<br />
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