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CI ient#: 675030 G LO BAPAYM E
<br /> DATE(MM/DD/YYYY)
<br /> ACORDT,, CERTIFICATE OF LIABILITY INSURANCE 1 1/06/2025
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 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 ISSUING INSURER(S),AUTHORIZED
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
<br /> IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
<br /> If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on
<br /> this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT Allison Peak
<br /> NAME:
<br /> Marsh & McLennan Agency LLC PHONE 706-324-6671 F IX 706-576-5607
<br /> A/C,No Ext: A/C,No
<br /> 200 Brookstone Centre Pkwy E-MAIL Allison.Peak@MarshMMA.com
<br /> Suite 118 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> Columbus, GA 31904 INSURER A:Federal Insurance Company A++XV 20281
<br /> INSURED INSURER B:ACE American Insurance Company A++XV 22667
<br /> TSYS Merchant Solutions, LLC
<br /> INSURER C
<br /> Attention: Devery Gauthier
<br /> INSURER D
<br /> 3550 Lenox Road NE, Suite 3000
<br /> INSURER E:
<br /> Atlanta, GA 30326
<br /> INSURER F
<br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS
<br /> LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y 36048071 04/01/2024 04/01/2025 EACH OCCURRENCE $1,000,000
<br /> CLAIMS-MADE 4 OCCUR PREMISESOEa occur°nce $1,000,000
<br /> MED EXP(Any one person) $1 U 000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
<br /> PRO
<br /> POLICY X JECT X LOC PRODUCTS-COMP/OP AGG $1,000,000
<br /> OTHER: Gen Agg Cap $100,000,000
<br /> A AUTOMOBILE LIABILITY 73614277 04/01/2024 04/01/202 COEaMBINED ccidentS INGLE LIMIT $1 e 000e 000
<br /> a
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> X AUTOS ONLY AUTOS ONLY Per accident $
<br /> A X UMBRELLA LIAB X OCCUR 79894591 04/01/2024 04/01/2025 EACH OCCURRENCE $25000000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE s25,000,000
<br /> DED RETENTION$ $
<br /> B WORKERS COMPENSATION 71750292 04/01/2024 04/01/2025 X PER OTH-
<br /> AND EMPLOYERS'LIABILITY STATUTE ER
<br /> A ANY PROPRIETOR/PARTNER/EXECUTIVE 71750293 04/01/2024 04/01/2025 E.L.EACH ACCIDENT $1,000,000
<br /> OFFICER/MEMBER EXCLUDED? N/A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> A Hired Auto 73614277 04/01/2024 04/01/2025 Actual Cash Value
<br /> Physical Damage $1,000 Comp Ded.
<br /> $1,000 Coll Ded.
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> First Named Insured: Global Payments Inc.&It's Subsidiaries
<br /> City of Santa Ana City, its officers,employees, agents,volunteers and representatives
<br /> (GL)Additional Insured per form: 80-02-2367 Additional Insured Scheduled Person or Organization
<br /> (GL) Primary and Noncontributory per form: 80-02-2653 Conditions Other Insurance Primary,
<br /> Noncontributory Insurance Scheduled Person or Organization
<br /> (See Attached Descriptions) APPROVED
<br /> CERTIFICATE HOLDER CANCELLATION By Cynthia Mora at 2:56 pm, Jan 14, 2025
<br /> City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 20 Civic Plaza 4th Floor
<br /> Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE
<br /> ©1988-2015 ACORD CORPORATION.All rights reserved.
<br /> ACORD 25(2016103) 1 of 2 The ACORD name and logo are registered marks of ACORD
<br /> #S14677713/M 13858229 J LMAP
<br />
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