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Last modified
8/29/2016 4:14:27 PM
Creation date
2/9/2015 8:43:59 AM
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Template:
Contracts
Company Name
VENTIV TECHNOLOGY
Contract #
A-2014-241
Agency
PERSONNEL SERVICES
Council Approval Date
10/21/2014
Expiration Date
9/30/2016
Insurance Exp Date
5/11/2017
Destruction Year
2021
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A� j`� CERTIFICATE OF LIABILITY INSURANCE <br />10/24/2014 <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 8Y 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(les) must he endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this centificets does not confer rights to the <br />certificate holder In lieu of such endomement(s). <br />PRODUCER <br />Equity Risk Partners, Inc, <br />License No. OD21146 <br />456 Montgomery St, Suite 1600 <br />San Francisco CA 94104 <br />CONTACT Partners Service GroUp <br />PHONE . (415)874-7168 FAX Ntj.(41$)074-7170 <br />'r'lAl�$$,PegEquityrisk.com <br />INSURERS AFFORDING COVERAGE NAIC# <br />INSURERA:Travelers Indemnity Co, of Am 25666 <br />INSURED <br />Vantiv Technology Inc. <br />3350 Riverwood Parkway <br />Suite 60 <br />Atlanta GA 30339 <br />INSURERB:Traveler6 Indemnit Co. of CT 25662 <br />INSURERC.Travelers Prop. Casualty of Am 25674 <br />INSURER D: <br />INSURERE: <br />NSURERIF <br />COVEKAGES GERrIFICAT'E NUMBER:CL149215172 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 CONTRACT OR 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 />INR <br />TYPE OF INSURANCE <br />AUDL <br />BR <br />PO E <br />POLICY EFF <br />MM OpYEXp <br />LIMITS <br />A <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE � OCCUR <br />309E758405 <br />/29/2014 <br />/29/2015 <br />EACH OCCURRENCE $ 1'000,000 <br />GE REMO <br />$ 300,000 <br />MED E(P AT one mon) $ 10,000 <br />PERSONAL B ADV INJURY $ 1,000,000 <br />GCNERALAGGREGATE $ 2,000,000 <br />GEKLAGGREGATELM9TAPPLIES <br />POLICY <br />PER <br />PRO- LOC <br />PRODUCTS - CAMPIOPAGG $ 2,000,000 <br />$ <br />$ <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />ALL OWNED No <br />AUTOS <br />X HIREDAUTOS Y' AUTOSWNED <br />E766046 <br />/29/2014 <br />/29/2015 <br />OMBINED SINGLE 1,000,000 <br />BODILY INJURY(Perpereen) $ <br />BODILY INJURY (Per accident) $ <br />Pegg tDAMAGE $ <br />Dedun ble: Com Colliston $ 100/500 <br />C <br />X UMBRELLA UAB <br />EXCESS UAB <br />[9 <br />OCCUR <br />CLAIMS4IADE <br />=29E758405 <br />/29/2014 <br />/29/2015 <br />EACH OCCURRENCE $ 10,000'000 <br />AGGREGATE $ 10,000,000 <br />ED I X I RETENTIONS 10,OOC <br />$ <br />C <br />WORKERS COMPENSATION <br />AND EMPLOYERS'LIABILITY <br />ANY PROPRIETORIPARTNERIEXECUTME VIN <br />OFFICEWMEMSER EXCLUDED? <br />(Mandatory in NH) <br />If Yes tlescdbeunder <br />D SLtRiFTION OF OPE TIONS below <br />NIA <br />OS260676 <br />/29/2014 <br />/29/2015 <br />X We S A - I OTHTORY 1-IMITE; - <br />E.L. EACH ACCIDENT $ 1 000 000 <br />E.L. DISEASE -EA EMPLOYEd$ 1 000 000 <br />EL. DISEASE - POLICY UMIT I $ 1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AMCbACORDdei,Add!Uonal Remarks SCMula,#maespace Isr ulrem <br />Evidence of Insurance <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Evidence of Insurance ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />Anthony Maxcon/MARTS <br />ACORD 25 (2010105) U 1988.2010 ACORD CORPORATION. All rights rese <br />INS0251pnimmm Th. ArnPn Ar!nan <br />
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