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PROOF OF INSURANCE (2019 - 2019) CLOSED LIBRARY-01 ASHLEYLANCTOT CERTIFICATE OF LIABILITY INSURANCE DATE IMM/ � 08/30/20182018Y) 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 N CT Elena Carbone NFP Property&Casualty Services,Inc. PHONE FAX 707 Westchester Avenue IAIC,No,ExtI; IAIc,Not? Suite 201 E-MAILelena.carbone elena.carbone@nfp.com Plains,NY 10604 ADDRESS. pcom INSURER(S),AFFORDING COVERAGE NAIC 9 INSURERA:Philadelphia Indemnity Insurance Company 18058 INSURED Library Associates,LLC LibSource,LLC PRO-TEK INSURER B:Hanover Insurance,Company 122292 Vaults,LLC INSURERC: Robert Corrao INSURER D: 51 Monroe St Ste PE04 Rockville,MD 20850 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 . T.S..RR._ TYPE OF INSURANCE ANSSE!WV0 POLICY NUMBER 1 ftdlNlL�T.C1,!Y 2caI,.laPAmiDI ffYYYt_ LIMITS A X COMMERCIAL GENERAL LIABILITY , EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE occuR PHPK1835170 06/01/2018 0610112019 DAMAGE TO RENTED 100,000 X X PREMISES(Fa,ciccorrenrek $ MED EXP(Any one person) $ 5,000 PERSONAL BADV INJURY $ 1,000,000 GEN1AGGREGATE LIMIT APPLIES PERGENERAL AGGREGATE $ 2,000,000 POLICY 3EII?" LOC PRODUCTS;COMP/OPAGG $ 2,000,000 OTHER: j $ _A AUTOMOBILE LIABILITY COMBINED SINGLE L,IMI"t 1,000,06-0 ANY AUTO PHPK1835170 1 06/01/2018 06/01/2019 1"(Ea LYid $ I BODILY,IINJURY y;Perlrersgav'p, $ OWNED SCHEDULED DpLY'VN',B,t1RY,µPereGride�o„dJ $ AUTOS ONLY AUTOS HIRED ''y N��¢¢d�p d, ''w PROFv'FI"t"R'Y(7AMAw{.roC•• AUTOS ONLY AV,dl'4,757 ,k' (�'rr,gra:a;der7C� $ $ AN'F UMBRELLA LIAB X OCCUR EACH OCCI„IRRF;N'vE $ EXCESS IAB CLAIMS-MADE PHUB633351 06/01/2018 06/01/2019 AGGRB GATE $ DED , XRETENTION$ 10,000 510001,000 S 5,000,000 WORKERS COMPENSATION PI:R 077, -------- - -- -- AND EMPLOYERS'LIABILITY Y I,N .$TATUIE ER gAq�']}N}..Y PROPRIETOR/PARTNER/EXECUTIVE E L EACH�ACCADEN'T $ (MP9dAIRigr/Mry fn NH)EXCLUDED? N/A E L DI'SEA'SE•EA EMFa'I'.�()YEE $ l yes,describe under DESCRIPTION OF OPERATIONS below _ - E IL D]SEA'SE•P0i.1(,Y IJlMIT $ A Equipment Floater/Co IPHPK1835170 06/0112018 06101/2019 E8O 3,000,000 B Crime 11048665 12/31/2017 12/31/2018 Crime 3,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I 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).Waiver of Subrogation in favor of the Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Ci of EI Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City g ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street EI Segundo,CA 90245 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: PHPK1835170 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s)Or Organization(s) City of Segundo V Information required to complete this Schedule, if not shown above,will be shown in the Declarations. Section II — Who Is An Insured is amended to in- clude as an additional insured the person(s) or or- ganizations) shown in the Schedule, but only with respect to liability for "bodily injury", "property dam- age" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 20 26 07 04 ©ISO Properties, Inc.,2004 Page 1 of 1 0 POLICY NUMBER: PHPK1835170 COMMERCIAL GENERAL LIABILITY CG 20 26 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): City of Segundo Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III—Limits Of Insurance: with respect to liability for "bodily injury", "property If coverage provided to the additional insured is damage" or "personal and advertising injury' required by a contract or agreement, the most we caused, in whole or in part, by your acts or will pay on behalf of the additional insured is the omissions or the acts or omissions of those acting amount of insurance: on your behalf: 1. In the performance of your ongoing operations; 1. Required by the contract or agreement; or or 2. Available under the applicable Limits of 2. In connection with your premises owned by or Insurance shown in the Declarations; rented to you. whichever is less. However: This endorsement shall not increase the 1. The insurance afforded to such additional applicable Limits of Insurance shown in the insured only applies to the extent permitted by Declarations. law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 26 0413 ©Insurance Services Office, Inc., 2012 Page 2 of 2 POLICY NUMBER: PHPK1835170 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON 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: PHPK1835170 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 0 Insurance Services Office, Inc., 2008 Page 1 of 1 ❑ T3-L29 DATE( DNYYY) ACC>RL CERTIFICATE OF LIABILITY INSURANCE 1%_� 6/28/2018 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 pollcy(les) 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 ondor^sement(s)„ PRODUCER CONTACT Risk Mena e-rient 1. ep'adi0lent Commercial Lines PHON. 9 work.t o(r1)( prunrat. (AJC,z%c () 8„66443-8489 INC,Me). 800-889-0021 IKON USI Insurance Services National,Inc. (AJC, l _rcarTi 2601 South Bayshore Drive,Suite 1600 INSURER(S)AFFORDING COVERAGE NAIC 0 Coconut Grove,FL 33133 INSURER A: ACE oa)ny 22667 INSURED American Insurance Company INSURER B TriNet HR III,Inc. INSURER C: L/C/F Library Associates,LLC dba LAC Group INSURER D 9000 Town Center Parkway INSURER E 4 Bradenton,FL 34202 .INSURER F COVERAGES CERTIFICATE NUMBER: 13,246106 REVISION NUMBER: See below THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMtsa.)ABOVE f'"Ohl'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 RAID CLAIMS. POLICY IEXP LTR TYPE OF INSURANCE I,MSD wVD� POLICY NUMBER L4MICpryEV.MFF YI. (MMIDDIYYYY) LIMITS IN' POLICY COMMERCIAL GENERAL LIABILITY EACH O=URRENCh S I)AM,AC(TO rel N'rl 0 CLAIMS-MADE „ OCCUR &P�d' E t(rr to+:caraoernc.vy S PIq I MED EMP(Any one person6 S „ PERSONAL&ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES LOC GENERAL AGGREGATE 15 POLICY PRODUCTS YI P AGG S It,,I1 S AUTOMOBILE LIABILITY I COMM NEF.0 SI N4,L L IMIT �. .•`.—S ,JFap,t'''r-1r� _ ._.... ._-.-.- ANY AUTO BODILY (Per person) s OWNEDSCHEDULED � BODILY INJURY(Per accident) S UNOD OS ONLY TOS ON , ...... S UMBRELLALIAB OCCUR EACH SEXCESSLIAB ,CLAIMS-MADE AGRCGA A AND EMPLOYERS''LABILITVRETENTIONS Y 1 N WLR C65555542 7/1/2018 7/1/2019 x ,gAxGiT „�°R” WORKERS COMPENSATION OFFICERIM M EREXCLU ED?ECUTIVE N NIA S Z,o irt��rtD,i�f'�i,D E L EACH ACCIDENT If xes.d(Manclat®rrvb�e under .m LIMIT... �, DESCRY TION OF OPERATIONS below E L DISEASE-POLICY �S ,:,,gpui�ilp u;glyr�� ryI E L DISEASE-EA EMPLOYEE; .............. ...... ..., DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe 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, CERTIFICATE HOLDER CANCELLATION City of EI Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. EI Segundo,CA 90245 AUTHORIZED REPRESENTATIVE 9e „` The ACORD name and logo are registered marks of ACORD ©1988-2015 ACORD CORPORATION. All rights reserved ACORD 25(2016/03)