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PROOF OF INSURANCE (2016) CLOSEDClient#: 299388 LIBRARY DATE (MM /DD/YYYY) ACORD,M CERTIFICATE OF LIABILITY INSURANCE 7127/z015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. ly holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS IMPORTANT: If the certificate WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such andorsement(s), PRODUCER CONTACT Maria Morales HUB International PHONE 805- 879 -9525 805 -617 -1767 Arr Nn HUB Int'I Insurance Serv. Inc. em°A°L s maria,,morales@hubinternational.com 40 East Alamar Avenue - - coveaacE NAIC p Santa Barbara, CA 93105 INSURE'R(S'�_A��r�OrkDINffi INSURER A: Philadelphia Indemnity Insuranc '..18058 INSURED INSURER B Library Associates, Inc. 51 Monroe Street, Suite PE-04 Rockville, MD 20850 -2442 COVERAGES CERTIFICATE NUMBER: INSURER C ; INSURER D: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I LT AR GENERAL LIABILITY OF INSURANCE ADD PHPK1336101 UMeE6 /011 015 06/071201i- COMMERCIAL EACH OCCURRENCE uMITS$1.000:000 ... A UMBRELLA LIAB OCCUR ..._ EXCESS LIAB CLAIMS —u - DED T XrRETENTION E1 0000 E ;Ns IS1 X� PERSONAL 8 ADV INJURY GENERAL AGGREGATE GLAIM$-MADE ER OCCUR $2.000.000 GrN'L AGGREGATE LIMIT APPLIES PER: POLICY 2L-1:1 r.00 A AUTOMOBILE LIABILITY LE'L'IM °v 0,000.000 ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per aceldenl) AUTOS X NON-OWNED HIRED AUTOS AUTOS A UMBRELLA LIAB OCCUR ..._ EXCESS LIAB CLAIMS —u - DED T XrRETENTION E1 0000 E ;Ns IS1 S AND EMPLOYERS' LIABILITY °'-"' ANY' PROPRIETOR/PARTNER/EXECUTIVE YIN E_,L EACH ACCIDENT OPFIOER/MEMBER EXCLUDED? N/A .. ( ry ) $ rifaaldelo In NH E.L. DISEASE -EA EMPLOYEE. Ifyes, describe under DESCRIPTION OF OPERATIONS below E.L„ DISEASE- POLICY LIMIT $ A Professional Liab PHPK1336101 6/01/2015 06/01/2016 Limit $1,000,000 A Erisa Bond PHSD1036378 0610112015 'i06/011201 Limit 3,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Certificate Holder is named as additional insured under the general liability policy as required by written contract per form CG2026 0704 attached. �il- RL110,111011qLA City f El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y o g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main St. ACCORDANCE WITH THE POLICY PROVISIONS. El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE ©19BB -2010 ACORD CORPORATION. All rights reserved„ ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S36284011M3548883 MM496 PERSONAL 8 ADV INJURY GENERAL AGGREGATE $1.000.000 $2,000,000 PRODUCTS - COMP /OPAGG $2.000.000 PHPK1336101 6/0112015 06/01/2016 LE'L'IM °v 0,000.000 BODILY INJURY (Per person) $ BODILY INJURY (Per aceldenl) $ PROPERTY DAMAGE $ Per accident $ PHUB499513 --1610112015*/01/2010 EACH OCCURRENCE 54,000,000 S AND EMPLOYERS' LIABILITY °'-"' ANY' PROPRIETOR/PARTNER/EXECUTIVE YIN E_,L EACH ACCIDENT OPFIOER/MEMBER EXCLUDED? N/A .. ( ry ) $ rifaaldelo In NH E.L. DISEASE -EA EMPLOYEE. Ifyes, describe under DESCRIPTION OF OPERATIONS below E.L„ DISEASE- POLICY LIMIT $ A Professional Liab PHPK1336101 6/01/2015 06/01/2016 Limit $1,000,000 A Erisa Bond PHSD1036378 0610112015 'i06/011201 Limit 3,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Certificate Holder is named as additional insured under the general liability policy as required by written contract per form CG2026 0704 attached. �il- RL110,111011qLA City f El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y o g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main St. ACCORDANCE WITH THE POLICY PROVISIONS. El Segundo, CA 90245 AUTHORIZED REPRESENTATIVE ©19BB -2010 ACORD CORPORATION. All rights reserved„ ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S36284011M3548883 MM496 PI•MANU -1 (OiIDU) wl. 1 7 Iti�i dpi r I•Icwt 1 1 Pty LIDS ". d�fml s d� d fa t7° t 1 1 "t Ll „y CG2026 Additional .insured - Designated Person Or Oruan-eation POLICY InJ)(OCR c'OIa1LacU� culr£nnL A OISPICL0279 L 2 „. CG 20 26 07 T 04 ° THLS CIr0.'1R5'e1SEtl2 CHIttG�c •r11k BOLICV. PLSASr• Re:S+ IT CARCFJ e.L1. ADDITIOMM, IHSUSeu - O- esIclLkriRO [?Pit—( M ORGAITFZATIO)T TU-1, ondorme.nenr a.oiisias IluuCallca ProvidcI under the EoUcwLlgr COMMACIA.b Ge11139AL I;YIOILt17 COVELFmc• PAR? • SCUMTE Name of Additional Itleurcd pLrooll Is) o= oruRniasUon (a) Ally paisoh or ozr�enixntiml otiior than a joint kOnLuYa tillon you lice caqul_ -od to add as an additional insured on this policy uudur tt I'MiL'ten ealttroet of agraomont: provided L•hmt the contract or agrooment Ls In effect: during this policy period and Ma axaeucad price me tha occurrellce Idlich souses '•.Ijed$ly injury ", "pronerty daraga" or "ps =send injttry and advertising inju_ -y”. thhan also raeuirad by rrcitbcn Conlrset or Agraeman:, this ivaeranco allal.l be primary and ron- contributory r:l.`..11 rvypocc ro etllar insurance, Seccicn Ll - 61ho Is pn InSUt2d is 5randed Lo inclltde, is an•aadiL•ional in "red LI1•a parach(s) or orgbVk- ,htiar,(s) sim4n ifl the Sehadule, buL only Mid] respect to 11mbiltty £or "bodily lojery ', °p= operLy . dnM. ;GO' or "Porronrl. mud advettising llljurp" ceased, l.n 1411010 01 ilt (tart, 1,1, Your rota or anis.m-M,- or talc arcs or Oaiasions of Cilesc meting oa your 1uha1F: In tut lls,r?orr,ance c: yaur onnoing operatio%l.^: or 6. sn c0000CLion with 2, l,ur Ilaygniss cwncc by or ranted to you. 'rha Insur6ticc. d0• ?s .lot a pp"Ay t0 "11aJSiy injury" or "proparty dr.maga' .wiling out n_ or SeSUlt -thq, CE''04 structural alcar:.t.ioalK, new eonst'ruek o11 or d ?,,0j L.on 000ratiens parP.oraW by or. Ear lint• eddit;.onnl insured. This insllranca cloov nee apply Lo "l+cdily injur;" a:' "r,= gerty danaye All other leans and condi((ons of II 'Nubby remain uroha' aged. Page l or x PHdAl4U,l (01100) arlz-'lv out of or X&DUlting from ally 41MICAllicnN Verfacmed by or fol- any CtILIX'CO-1, mm'),-.4PALLY, entity or otljor pub2la ThiM biumthncz cjo*s not aMj2.y p cut Or 09 VesuUlnq frft - .0 bodily injv-,ry,, or "PropQrLy da%l;Wl arlsiAg wsy Optratinaz percormd by cc fou any Lalomari::rin0. CH-I:ect "Oil CX cc 20 20 07 04 0 ISD PropartAor., Inc., All olhar Terms and concilliont; ofilik'PoUcy remain u4hsnqLa rage 2 of 2 Client #: 299388 LIBRARY DATE (MMIDDIYYYY) ACORD., CERTIFICATE OF LIABILITY INSURANCE 11121/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the cart&fioate hoNder is an ADDITIONAL INSURED, the laolicy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s), PRODUCER COI�iIA T Maria Morales NON Hub International FIIONE FAX -1 7i TI AIC rao, EYD: 805- 879 -9525 Inm N 805- 617 -1767 HUB Int'I Insurance Serv. Inc. EMAIL maria.moralles@fiubinternaional.com 40 East Alamar Avenue INSURER(S) AFFORDING COVERAGE'. NAIC # Santa Barbara, CA 93105 INSURERA :Philadelphia Indemnity Insuranc 18058 INSURED INSURERS; Hartford Casualty Insurance Com 129424 Library Associates, Inc. � IER INSURRER C 51 Monroe Street, Suite PE -04 INSURER D Rockville, MD 20850 -2442 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ERR".'- TYPE OF INSURANCE AD DL uUBR - POLICY NUMBER ''— � IMMIDD{YYYV MMIDD YYYY LIMITS ." " " PO A GENERAL LIABILITY PHPK1027414 6101/2014 06/01/2015 EACHOCCURRENCE 51,000;,000 X COMMERCIAL GENERAL LIABILITY DAMAGTO "riLNTEL 5100-000 FNdLMI » S IWa oarutenret..... CLAIMS -MADE rid OCCUR MED EXP (Anv one Derson) S5.000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE s2.000,000 GENL AGOG EGATE'. LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG 52,000,000 POLICY.. LOC $ A AUTOMOBILE LIABILITY PHPK1027414 610112014 061011201 COMBINED SINGLE L,IMI r ',F m "_ -,,.i 51,000,000 BODILY INJURY (Perpersan) 5 X ANY AUTO BODILY INJURY (Per accident) S ALLOWNED SCHEDULED AUTOS NON-OWNED X X PROPER-77 UA_WAG _ ..� $ HIRED AUTOS AUTOS .a._..._.._.... "i 5 � A UMBRELLA LIAB OCCUR PHUB422451 0610112014,0610112015 EACH OCCURRENCE 54000.000 EXCESS LIAR CLAIMS -MADE 4.000.000 AGGREGATE "L; s4.000.000 S. ENTION 0000 5........._._., arc B 72WECFY5738 12101/20 12/011201,,4 "YN' T OTH AND EMPLOYERS' LI BILITY NWORKERS P LOYERS'c��RrNI R� YIN '�OFFMERI10EMBER.E�.X�CLUDED. N � E.L. EACH ACCIDENT $1,000,000 I _.. _... .NIA EL DISEASE EMPLOYEE 51,000790'0 Mandatory in NH ( ) E.L. -E ... -- ._ ..,c_. If yes, describe under nFSCRIPTION OF OPERATIONS below E.L DISEASE- POLICY LIMIT ,000,,000 • Professional Liab PHPK1027414 0610112014 06101/201 Limit $1,000,00 • 'Erisa Bond PHSD848634 6/01/2014 06101/201 Limit $3,000,000 DESCRIPTION OF OPERATIONS! LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Certificate Holder is named as additional insured under the general liability poiicy under written contract perform CG2026 attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of El Segundo Y g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main St. ACCORDANCE WITH THE POLICY PROVISIONS. EI Segundo, CA 90 4 AUTHORIZED REPRESENTATIVE ©1988 -2010 ACORD CORPORATION. All rights reserved, ACORD 25 (2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S3200688/M2900952 MM496 niwk- THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. VVIs1kyjN X60&o1llJ 77 Eel: 11dt Eel 7 *0101TI 1 ;-a a:To]u1 OTHERS ENDORSEMENT - CALIFORNIA Policy Number: 72 WEC FY573,/ Endorsement Number: 01 Effective Date: 12/01/14 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: LIBRARY ASSOCIATES, INC 51 MONROE ST STE PE04 ROCKVILLE, MD 20650 We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be premium otherwise due on such remuneration. Person or Organization CITY OF EL SUD 350 MAIN ST. EL SEGUNDO, CA( 02 45 SCHEDULE Countersigned by 2 % of the California workers' compensation Job Description TEMPORARY LIBRARIAN Authorized Representative Form WC 04 03 06 (1) Printed in U.S.A. Process Date: 12/02/14 Policy Expiration Date: 12/01/15