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QLIEEBOR-02 <br />CERTIFICATE OF LIABILITY INSURANCE $1212017 <br />THIS CERTIFICATE IS ISSUED ASA MAI TER OFINFORMATION 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 -I SSUINGJNSURER(S),AUTHOR17.EQ <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, <br />IMPORTANT: It the certificate holder is an ADDITIONAL INSURED, the policyHos) must have ADDI ]'TONAL INSURED provisions or be ofldorsod <br />If SUBROGATION IS WAIVED, Subject to the'totals and conditions of the policy, certain policies may require an codorsernent, A stitoonanton <br />this carNficata does not confer Ngot5 to the certificate holder in Ileo ol such errdojsement(s), <br />PROIIl,C'c P. CON FACI <br />NANE <br />'Arthro' J. Gallagher Risk Management Services, INC, P"ONErAX <br />one joncro Plaza suits '100 (A'C 4., E,,, (5 16) 745.0800 rr c' N,(516)745 -0082 <br />Jericho, NY 11753 A' MAIL <br />LRSSS <br />INSURERal AFNOROCC COVERAGE NAIC 4 <br />rN3IA&O A, Fede ral III C cimpany 20281 <br />ITISUPIED ers,,RER a Great Northern Insurance Company 20303 <br />Cascara Borough Public Library MSURFR c: <br />69-11 Merrick Blvd. III D, <br />Jamaica, NY 11452 INSURER E: <br />INSURER P <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />H q3 IS TO CERT IF Y THAT 'FHE POLICIES Or INSIJR,4INCF LISTED ED BELOW HAVE SEEN ISSUED 1'0 THE IPC.3URED NAMED ABOVE FOR P HE POLICY PERIOD <br />INDICATED NOT V'jI I'HS I ANDING ANI RIE'JOIREMEN I` rERM OR GONDI 1 ION OF ANY CON liRArT 0RorPER DOCUMEN I vI TH RESPECT TO 0I I'Ji rIc <br />C - AfFORCED ' <br />-ERIII-ICAIC MAY BE 13SUEL, OF MA'S PEHrAIN r, -IF 4,13URANCE ,,Y THE POLICIES DESCRIBED HCREINIS SUBJECT rOALL-PIETE:RNIS <br />EXCLU,Sn)NS AND CONDI LIONS CJP SUCK POI OCIES I-ItAir8SHODYliN MAY HAVE BEEN REDUCGJ fat LAID CLa1lNi5 <br />Ifl,R AOOL 5U9IR POLICY EFF POLICY EXP <br />LrFt TYPE OF INSURANCE _tlPOLCYNUMBE. LIMITS <br />A X comSieA<eALGeNEAA1LUAdnLor( <br />X <br />GL --99.496992 0610112017 0610112018 <br />X .. .... FICIIAPLI <br />An P)MORILe LIAEOLITY <br />X <br />UMBRELLA LIAR j, -p <br />EXCESS LIAR . - A, A- 't <br />WORKSIS COMPFNSATION <br />ANN EMPLOYERSYLIASOLITY Y.N <br />NIA <br />rQjI "N <br />-l'.L "L 1110 <br />P.daya <br />OFSCRIPTION OF OPERA nONS LOCAf IONS; VEHIQ- 65 <br />ADDITIONAL INSURED PER FORM 980�02-2367 05-07 <br />I.The City of Seats Ana, its officers, employees. agents, and representative are included as Additional Insured$ . <br />' — <br />CERTIFICATE HO! )ER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NONCE WILL BE DELIVERED IN <br />City of Santa Ana ACCORDANCE WITH ME POLICY PROVISIONS, <br />Attry PRCSA <br />20 Civic (,enter Plaza -Ross Annex - ----- <br />Santa Ana, CA 92701 All TI ORIZU) REPRC'n.14 NIPVC <br />ACORD 27120'14/031 9,1938-2015 ACORD CORPORATION. All rights fasorved <br />The ACORD Name SOOT logo are registered marks of ACORD <br />