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A� [a CERTIFICATE OF LIABILITY INSURANCE o5/11/2017�
<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 iii 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 NAME�VI Nancy Stottlemyer
<br />.. ., ._...........
<br />Insurance Brokers of HD - Hagerstown PHONE (301)790-0652 (A/AC,NoJ: (301)790-0962
<br />_fE L&N�tl.—__.__
<br />__.
<br />13126 Pennsylvania Ave. .ADDREssnaney, stottlemyer@ibmofmd com
<br />PO Box 3767 IgSIIn GI.I arcnoo,uc envecaee ...
<br />Hagerstown MD 21742 .IN$URERA Atl.antiC_Special Ins. CO 27154
<br />INSURED ...... d INSURERS
<br />The Library Corporation '¢ ..«D Li )�^ INODRER C:
<br />_._.. ._. .............----------- _—.______
<br />Carl Corp.and Tech -Logic Corp. INSURER D: _
<br />1 Research Park INSURER E:
<br />__. ......._....... _ . _..............
<br />Inwood WV 25428-9733 INSURER F:
<br />COVERAGES CERTIFICATE NUMBER 2017-2016 DRA/15I(TM MIIMRFR-
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION
<br />OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />iNSRT —.._ .."- ADDL`5067["._. . _ _.__._--
<br />POLICY EFF POLICY E%P _ ...'_. ____ .__ __-- __.__._
<br />..._......__..__.__
<br />LTR' TYPE OFINSURANCE POLICY NUMBCR
<br />MIODIYYYY MMIOD/YVYY LIMITS
<br />X COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE '$
<br />1,000,000
<br />i
<br />A CAIM9"MADE _XkOCCUR
<br />rb7♦VAi ZEfi6RENTEb
<br />PRE_L5E$.(Reosgy� e)_ ®_
<br />1,000,000
<br />I R (71101S8A6
<br />] 5/8/2017 5/8/2018 MED EXP (Any oneTerson)
<br />10,000
<br />.y$
<br />1$
<br />11000,000
<br />GENE AGGREGATE
<br />GATE LIMIT APPLIES PER:',
<br />[GENERAL ACGRE_GATE i$
<br />2,000,000
<br />.._1POLICY!X PRO [LOC
<br />_
<br />,PRODUCTS-DOMPIOP
<br />AGG i$
<br />2,000,000
<br />OTHER:
<br />IEmployso BsnoOts j$
<br />1,000,000
<br />AUTOMOBILE LIABILITY
<br />COMBINED SINGLE LIMIT
<br />___1
<br />0-0-o".0-0-0,
<br />A , X� ANY AUTO
<br />BODILY INJURY (Per person) ff
<br />-: ALL OWNED - SCHEDULED
<br />AUTOS AUTOS .71101584B
<br />5/8/2017 5/8/2018 BODILY INJURY (Per accident) S
<br />X 'NON OPMED
<br />X_
<br />HIRED AUTOS , AUTOS
<br />I y(par eccdantl. _$_.
<br />$
<br />X UMBRELLA LIAR 'LX i
<br />I OCCUR!
<br />EACH OCCURRENCE
<br />EXCESS UAB
<br />A i_ CLAIMS -MADE
<br />.-EA
<br />_ AGGREGATE $
<br />1D ^ RETENTIONS 01 1711015848
<br />5/8/2017 5/8/2018 1 $
<br />WORKERS COMPENSATION
<br />H
<br />IXI&TATUTE__
<br />AND EMPLOYERS'LIABILITY YIN
<br />ER
<br />I_EL
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE-,I
<br />IOFFICER,MEMBER EXCLUDED? N NIA'
<br />EACH ACCIDENT $_
<br />11000,000
<br />---
<br />A [(Mandatory In NH) "'-' W406044542
<br />5/8/2017 5/8/2018 ;EL DISEASE -Eq EMPLOYEE .W
<br />1, 000. OOP.
<br />e.....
<br />If ss, describe untler
<br />_ -----..._
<br />_
<br />DESCRIPTION OF OPERATIONS below (includihy CA Cam A)
<br />EL DISEASE -POLICY LIMIT I $
<br />1,000,000
<br />A I. E60, Information RiskI TTS760010008- Claims Made 5/6/2017 5/8/2018 Combined Liability Limit
<br />$5,000,000
<br />6 Communication Liability ($25,000 Retention
<br />[Maximum Policy Aggregate
<br />$5,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schodulm may be attached If more space is required)
<br />City of Santa Ana, It's Officers, employoes, agents, volunteers and representativ re additional
<br />insured as indicated, and coverage is primary, non-contributory when required_ bX(�y�1tten contr t per
<br />attached form VCG207 (11/13)
<br />00
<br />SHOULD ANY OF THE 990VE DESQ�ffed POLICIES BE CANCELLED BEFORE
<br />City Of Santa Ana THE EXPIRATION DATE THERE F, NOTICE WILL BE DELIVERED IN
<br />20 Civic Center Plaza M-30 ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Santa Ana„ CA 92701
<br />AUTHORIZED REPRESENTATIVE
<br />Nancy Stottlemyer/NLS
<br />©1988-2014 ACORD CORPORATION. All rights reserved
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />INS025 imnIAOt1
<br />
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