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PROOF OF INSURANCE (2018 - 2018) CLOSED
LIBRA-3 OP ID:RK ACORO CERTIFICATE OF LIABILITY INSURANCE DA 06/21/2017TE Y) 06/21/2017 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 certificate holder is an ADDITIONAL INSURED, the policy(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 CONTACT NFP P&C NFP Property&Casualty HONE FAX Services,Inc. (Arc No,Ext):914.683.3990 (A;rc,No): 914.948.9560 707 Westchester Ave.,Ste 201 E-MAIL White Plains,NY 10604 ARDIRM: NFP P&C Services,Inc. INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Philadelphia Indemnity Ins.Co 18058 INSURED Library Associates„LLC INSURER B:The Hanover insur L'ib'Source,LLC rance Company .... 22292 PRO-TEK Vaults,LLC INSURERC: see notes for full list INSURER D 10390 Santa Monica Blvd.#230 Los Angeles,CA 90025 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 INSIR . ......TYPE..OP..INSURANCE..........................................INSD WVD POLICY NUMBER ,�POLICY EFF 1 'POLICY EXP � .�.L..,al1EIt LIMITS MMIDDIYYYY) YMMd'DDBYY'YYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X DAMAGE TO F�dI.NT'S�I� CLAIMS-MADE OCCUR X PHPK1661910 06/0112017 06/01/2018 PREMISES)E rrrttrrrcatrc ) $ 100,000 MED EXP(Any one person) $ 5,000' PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PE LOC PRODUCTS-COMP/OP AGG $ 2,000,000' II AUTOMOBILE LIABILITY COMBINED$INOLE LIMIT $ 1,000,000 E I" A ANY AUTO PHPK1661910 06/01/2017 06/01/2018 BODILY INJURY(Per person) $ ALL OWNED rX SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOSPer ac RTYOA'P A0ENON-OWNED PRUPE' $ X HIRED AUTOS AUTOS ( ci;0epn EXCESS^LIALAB IOCCUR AIMS-MADE PHUB586180 06/01/2017 EACH OCCURRENCE $ 5,000,000 A X UMBRELLA s .....CL..................................... 06101/2018 AGGREGATE $ 5,000,000 DED I X RETENTION$ 10000 $ WORKERS COMPENSATION1 PI-R O'f'H- AND EMPLOYERS'LIABILITY Y1 N STATUTE u u ER ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A ,• (Mandatory in NH) E L,DISEASE-EA EMPLOYEE' $ If yes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ A Prof.Liability PHPK1661910 06101/2017 06/01/2018 E&O $2M aggreg B Crime 1048665 12131/2016 12/31/2017 Crime 3,000,000' ....................._.�......................_.......... DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Additional Insured status if required by written contract automatically granted per the General Liability Deluxe Endorsement(PI-GLD-TS(12/10). CERTIFICATE HOLDER CANCELLATION CITYE01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of EI Segundo ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street EI Segundo, CA 90245 AUTHORIZED REPRESENTATIVE //� n ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD .............. .............................................................. LIBRA-3 PAGE 2 NOTEPAD INSURED'S NAME Library Associates, LLC OP ID: RK Date 06/2112017 Named Insured: Library Associates, LLC dba LAC Group LibSource, LLC PRO-TEK Vaults, LLC Chase Cost Management, LLC Library Associates of Maryland, LLC Library Associates Holdings, LLC .................... ... POLICY NUMBER: PHPK1661910 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL I SURE - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: CBRE, Inc. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule as an insured but only with respect to liability arising out of your operations or premises owned by or rented to you. CG 20 26 11 85 Copyright, Insurance Services Office, Inc., 1984 Page 1 of 1 0 POLICY NUMBER: PHPK1661910 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - SIG A E RSO OR ORGANIZATION This endorsement modifies insurance provided under the following-, COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: City of Segundo (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule as an insured but only with respect to liability arising out of your operations or premises owned by or rented to you. CG 20 26 11 85 Copyright, Insurance Services Office, Inc., 1984 Page 1 of 1 0 POLICY NUMBER: PHPK1661910 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO CJS This endorsement modifies insurance provided under the following; COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: CBRE, Inc. , 28 Liberty St, New York, NY 10005 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule -�5u above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 ❑ POLICY NUMBER: PHPK1661910 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: City of Segundo Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 ©Insurance Services Office, Inc., 2008 Page 1 of 1 ❑ POLICY CHANGE DOCUMENT POLICY NO.: PHPK1661910 Philadelphia Indemnity Insurance Company 18718 N 11 FP 11 Propert 11 y y Ser11 vices I . ..,& Casual 11 ty nc. NAMED INSURED Library Associates, LLC LibSource LLC LibSource, LLC MAILING ADDRESS 51 Monroe St Ste PE04 Rockville, MD 20850-2442 POLICY PERIOD: FROM 06/01/2017 TO 06/01/2018 at 12:01 A.M. Standard Time at your mailing address shown above. CHANGE EFFECTIVE 08/01/2017 CHANGE# 1 REVISION # 1 DESCRIPTION In consideration of the premium reflected, the policy is amended as indicated below: ADDED: CG2026-Addl Insured-Designated Person or Organization CG2404 05/09 Waiver of Transfer of Rights of Recovery Against Others City of Segundo 350 Main St EI Segundo, CA 90245-3813 Per attached schedule and forms Path ID 10965060 Total Annual Total Prorate Additional/Return Premium$ 0.00 Additional/Return Premium$ 0.00 NO CHANGE NO CHANGE COUNTERSIGNED BY (Date) (Authorized Representative) 08/10/2017 Issue Date Insurance Policy Page 1 of 1 Philadelphia Indemnity Insurance Company Additional Insured Schedule Policy Number: PHPK1661910 Additional Insured 14 So. Williamsport Holdings, LLC c/o Balmer Park, LLC 445 Park Ave New York, NY 10022-2606 CG2011 - NY - Loc #3 Additional Insured American General Life Insurance Co., LPC West, LLC and Lincoln Property Company 26635 Agoura Rd Ste 255 Calabasas, CA 91302-3860 CG2011 - CA - Loc #4 Additional Insured Bruinbuilt, LLC Ontario 1 Management 1819 W Olive Ave Burbank, CA 91506-2435 CG2011 - CA - Loc #5 Additional Insured WRIT 6110 Executive Blvd Ste 800 Rockville, MD 20852-3927 CG2011 - MD - Loc #6 Additional Insured CBRE, Inc. 28 Liberty St New York, NY 10005-1400 CG2026 - General Liability Re: As Required by Written Contract Page 1 of 5 Philadelphia Indemnity Insurance Company Additional Insured Schedule Policy Number: PHPK1661910 Additional Insured Madison Capital Funding LLC, as Agent & its respective successors & assigns as Agent for itself & certain other lenders 30 S Wacker Dr Ste 3700 Chicago, IL 60606-7462 CG2018 - AZ - Loc #7 CG2018 - CA - Loc #1 CG2018 - CA - Loc #4 CG2018 - CA - Loc #5 CG2018 - CA - Loc #8 CG2018 - CA - Loc #9 CG2018 - CA - Loc #10 CG2018 - CA - Loc #11 CG2018 - CA - Loc #12 CG2018 - CA - Loc #13 CG2018 - CA - Loc #14 CG2018 - CA - Loc #15 CG2018 - CO - Loc #2 CG2018 - CO - Loc #17 CG2018 - CO - Loc #18 Page 2 of 5 Philadelphia Indemnity Insurance Company Additional Insured Schedule Policy Number: PHPK1661910 Additional Insured Madison Capital Funding LLC, as Agent & its respective successors & assigns as Agent for itself & certain other lenders 30 S Wacker Dr Ste 3700 Chicago, IL 60606-7462 CG2018 - CO - Loc #19 CG2018 - DC - Loc #20 CG2018 - DC - Loc #21 CG2018 - DC - Loc #22 CG2018 - DC - Loc #23 CG2018 - DC - Loc #24 CG2018 - DC - Loc #25 CG2018 - DC - Loc #26 CG2018 - DC - Loc #27 CG2018 - DC - Loc #28 CG2018 - FL - Loc #29 CG2018 - GA - Loc #30 CG2018 - IL - Loc #31 CG2018 - IN - Loc #32 CG2018 - LA - Loc #33 CG2018 - MD - Loc #6 CG2018 - MD - Loc #34 CG2018 - MD - Loc #35 CG2018 - MD - Loc #36 Page 3 of 5 Philadelphia Indemnity Insurance Company Additional Insured Schedule Policy Number: PHPK1661910 Additional Insured Madison Capital Funding LLC, as Agent & its respective successors & assigns as Agent for itself & certain other lenders 30 S Wacker Dr Ste 3700 Chicago, IL 60606-7462 CG2018 - MD - Loc #37 CG2018 - NY - Loc #3 CG2018 - NY - Loc #38 CG2018 - NY - Loc #39 CG2018 - NC - Loc #40 CG2018 - OK - Loc #41 CG2018 - PA - Loc #42 CG2018 - PA - Loc #43 CG2018 - PA - Loc #44 CG2018 - TX - Loc #45 CG2018 - TX - Loc #46 CG2018 - TX - Loc #47 CG2018 - VA - Loc #48 CG2018 - WI - Loc #49 CG2018 - WI - Loc #50 Additional Insured Washington Real Estate Investment Trust 1775 I St NW Ste 1000 Washington, DC 20006-2404 CG2011 - MD - Loc #6 Page 4 of 5 Philadelphia Indemnity Insurance Company Additional Insured Schedule Policy Number: PHPK1661910 Additional Insured City of Segundo 350 Main St EI Segundo, CA 90245-3813 CG2026 - General Liability Page 5 of 5 i r�ca CERTIFICATE OF LIABILITY INSURANCE ( DATE(M/201 YYY) C i��• 7/13/2017 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 certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or 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 CONTNAME: Risk Management Department Commercial Lines PHONE 866-443-8489 cFAX 800-889-0021 (A/C,No,s FwDrk.com) Irinet..om (ac,No): Wells Fargo Insurance Services USA, Inc. E-MAIL ADORLSS. INSURER(S)AFFORDING COVERAGE NA C 2601 South Bayshore Drive,Suite 1600 I Coconut Grove, FL 33133 INSURERA: ACE American Insurance Company 22667 INSURED INSURER B TriNet HR III, Inc. INsuRERc L/C/F Library Associates,LLC dba LAC Group INSURER D: 9000 Town Center Parkway INSURER E Bradenton, FL 34202 INSURER F: COVERAGES CERTIFICATE NUMBER: 12073265 REVISION NUMBER: See below 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. iNSR TYPE OF INSURANCE ADDL SUL912� ,. .... .(MMLICY EFF,�POLICY"EXP.LT ' LIMITS INSD WVD POLICY NUMBER IiMI'DD1VYYY'I COMMERCIALGENERAL LIABILITY EACH OCCURRENCE $ DAMAGE 'ICSk Ntf-Xi a�� CLAIMS-MADE OCCUR PREMISES a( I $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ ---- POLICY PPRO-RO- LOC PRODUCTS-COMP/OP AGG $ OIHI W S AUTOMOBILE LIABILITY .....LIN11.................$ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY AUTOS ONLY AUTOS (Per accident) S -- HIRED v aur .... ...... tYFL: fy�l....$.. Ii 4 _ I ............................. AUTOS ONLY AUTOS ONLY RY PI')A $ $ UMBRELLALIAB CCUR EACH EXCESS LIAB CLAIMS-MADE AGGRCGATE OCCURRENCE $ DED I. I RETENTIONS $ X I 0TH 2,000,000 A OFFICE PRIET R/PART ER/E YIN NIA WLRC64483213 07/01/2017 07/01/2018 L�E ... ... 1 ..,� ER AND EMPLOYERS'LIABILITY TATLITE WORKERS COMPENSATIONPER (Mandatory m NH) E L,,,,,,,ACH ACCIDENT $ 2 000,000 ANYPROPRIETOR/PARTNER/EXECUTIVE E, DISEASE-EA EMPLOYEE 5 If yes,describe under 2,000,000 DESCRIPTION OF OPERATIONS below E L DISEASE.POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation is limited to worksite employees of Library Associates, LLC, LAC Group through a co-employment contract with TriNet HR III, Inc. V/ CERTIFICATE HOLDER CANCELLATION Library Associates,LLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN dba LAC Group ACCORDANCE WITH THE POLICY PROVISIONS. 10390 Santa Monica Boulevard,Suite 230 Los Angeles,CA 90025 AUTHORIZED REPRESENTATIVE II 9e-4��- The ACORD name and logo are registered marks of ACORD ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103)