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Tori Pierson Date"20 0420082253eOPW CERTIFICATE OF LIABILITY INSURANCE DATE/29/202NM) 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 Marsh & McLennan Agency, LLC 2000 Brookstone Centre Pkwy Suite 118 Columbus GA 31904 NAMEA CT Connie Whitmer PHONE FAX 706-324-6671 A/c Mo:706-576-5607 ADDRESS: Connie.Whitmer MarshMMA.com INSURERS AFFORDING COVERAGE NAIC # INSURERA: Federal insurance Company A++XV 20281 INSURED 30GLOBALPAYM TSYS Merchant Solutions LLC Global Payments, Inc. & It's Subsidiaries INSURER B : Great Northern Insurance Company A++ XV 20303 INSURER c: ACE American Insurance Company A++XV 22667 INSURER D : One TSYS Way; C-4 Columbus GA 31901 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 652492694 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. INSR LTR rypE OF INSURANCE ADDL SURF POLICY NUMBER POLICY EFF IMWDDFIYfY1 POLICY EXP fMM/DDpYTYYJLIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ] OCCUR Y 36048071 4112022 41112023 EACH OCCURRENCE $1.000,000 ED ED DAMAGE —RENT PREMISESSRENT occurrence)$1.000,000 MED ENT (Any one person) $10,000 PERSONAL &ACV INJURY $1,00p000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JE� LOC GENERAL AGGREGATE $2.000,000 PRODUCTS - COMP/OP AGG $1,000,000 1 Gen ADD Ca $too 000000 OTHER: B AUTOMOBILE LIABILITY 736142P 4/1=22 411/2023 COMBINED SINGLE LIMIT Ea accident $1000000 X BODILY INJURY (Per person) $ ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ Hired Phy Deng - ACV $1.000 Deds X Hired Com 'X Hired Coll A X UMBRELLA LIAB OCCUR 79894591 4/1=22 4112023 EACH OCCURRENCE $25,000,000 AGGREGATE $25,000,000 EXCESS LIAB CLAIMS -MADE DIED RETENTION$ $ O A WORKERS COMPENSATION AND EMPLOYERS'LIASILITY YIN 71750292 71750293 4/1/2022 4112022 4/12023 V12023 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $1.000,000 ANY PROPRIETORIPARTNEWEXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? MIA E.L. DISEASE - EA EMPLOYEE $1.000,000 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below EL.DISEASE -POLICY LIMIT $1000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space is required) City of Santa Ana City, its officers, employees, agents, volunteers and representatives (GL) Additional Insured per form: 80-02-2367 Additional Insured Scheduled Person or Organization (GL) Primary and Noncontributory per form: 80-02-2653 Conditions — Other Insurance — Primary, Noncontributory Insurance Scheduled Person or Organization (GL) 45 Day Notice of Cancellation per form: 80-02-9779 Notice of Cancellation To Scheduled Persons or Organizations (Except Non-payment of Premium) City of Santa Ana Risk Management Division 20 Civic Plaza 4th Floor Santa Ana CA 92702 ,earLea�.au•Jcl SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Ppsta R a _ vr66tag.Il.aoMaan ' `' 1✓f41e1/EtiJ6 /NrRw®BY. :[ �RhkM„rra9.,,a,rue;�alade ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD v