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• <br />.4COstO CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MMODNYM <br />osrolno2o <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 endomement(s). <br />PRODUCER <br />Insurance Brokers of MD - Hagerstown <br />13126 Pennsylvania Ave. <br />PO Box 3767 <br />Hagerstown MD 21742 <br />NAMNTE:ACT Nancy Stottlemyer <br />PNONF (301)790-0652g6 (301)790-02 <br />ADoIiESS: ^ancy.stottlemyer@ibmotmd.com <br />INSURERS AFFORDING COVERAGE <br />NAIL S <br />INSURER A. Twin City Fire Ins. Co. <br />29459 <br />INSURED <br />The Library Corporation <br />Carl Corporation and Tech -Logic Corporation <br />1 Research Park <br />Inwood WV 25428 <br />INSURER8: Hanford A&I Co. <br />22357 <br />INSURER C , Hartford Fire Ins. Co. <br />19682 <br />INSURER D <br />INSURER E <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 CONTRACTOR 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 />TA <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />MMIDD/YYYY <br />MMIDO/YYYY <br />D�Ts <br />COMMERCMLGENERALLIABIUTY / <br />EACH OCCURRENCE <br />1,000,000 <br />E <br />V/ <br />CLAIMS,MADE ® OCCUR <br />/ <br />✓ <br />PR MI <br />E 1.000,000 <br />MED EXP (Any an ISM <br />E 10,000 <br />✓ <br />A <br />Y <br />30SBAVK5698 <br />05/08/2020 <br />05/08/2021 <br />PERSONAL a ADV INJURY <br />E 1,000,000 <br />GENT AGGREGATE LIMITAPPLIES PER: <br />POLICY PRG <br />JECT LOC <br />GENERALAGGREGATE <br />E 2,000,000 <br />PRODUCTS - GOMPIOPAGG <br />E 2,000,000 <br />I <br />S <br />OTHER <br />I <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />COMBINED SINGLE LIMIT <br />E 1.000,000 <br />BODILY IWURY(Per person) <br />E <br />g <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />30UECFP3134 <br />05/08/2020 <br />05/08/2021 <br />BODILY INJURY (Per sIxsent) <br />E <br />PR A <br />fps, susIsMt) <br />E <br />HIRED NONH0"ED <br />AUTOS ONLY AUTOS ONLY <br />E <br />UMBRELLA Use <br />OCCUR <br />EACH OCCURRENCE <br />E 6.000,000 <br />AGGREGATE <br />6,000.000 <br />A <br />EXCESS LIAR <br />CLAIMS-NLDE <br />30SBAVK5698 <br />05/08/2020 <br />05/08/2021 <br />DED <br />RETENTION 10.000 <br />It <br />WORKERS COMPENSATION <br />PER'N STATUTE TH- <br />ER <br />C <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETORIPARTNERIEXECtmVE Y N <br />OFFICERIMEMSER EXCLUDED? F <br />(MendMM ie NH) <br />NIA <br />30WECAD2KBN <br />05/08/2020 <br />05/08/2021 <br />E.L. EACH ACCIDENT <br />g 1,000,000 <br />E.L. DISEASE � EAEMPLOYEE <br />1 1,000,000 <br />if yes, descrloe under <br />DESCRIPTION OF OPERATIONS ilelmv <br />E.L. DISEASE- POLICY LIMIT <br />E 1,000,000 <br />C <br />E rSt' party Ex on Risk, Media Liability 8 <br />First Pany Expense <br />30TE0336969-20-Claims-Made <br />05roB/2020 <br />'� <br />05/08/2021 <br />✓ <br />Aggregate Limit <br />Each Wrongful Act <br />Retention <br />$5,000,000 <br />$5,000,000 <br />$ 25,000 <br />DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES (ACORD 101. AWKIo M Remarks Schedule. may W atUKhed N more sWe is requind) <br />City of Santa Ana, Its Officers. employees, agents, volunteers and representatives are additional insured as indicated, and Coverage is primary, <br />non-contributory when required by written Contract. CertlTicale of Insurance shall provide thirty (30) day prior written notice of cancellation. ./ <br />REVIEWED & APPROVED <br />By Risk MANAGEMENT DIVISION <br />City Of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza 4th FI <br />Santa Ana <br />ANffiE AmEdo <br />CA 92702 <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 />tc) 1gRRJ1115 <br />All rinhts reserveri <br />ACORD 25 (2016103) <br />The ACORD name and logo are registered marks of ACORD <br />