HomeMy WebLinkAboutTSYS MERCHANT SOLUTIONS, LLC (4)INSURANCE NOT ON FILE
,p%ftORK MAY NOT PROCEED
CLERK OF COUNCIL
DATE:
MAYOR
Miguel A. Pulido
MAYOR PRO TEM
Juan Vlllegas
COUNCILMEMBERS
Phil Bacerm
Nelida Mendoza
David Penaloza
Vicente Sarmienlo
Jose Solorio
p F-MS A (I, ;
CITY OF SANTA ANA
CITY ATTORNEY'S OFFICE
20 Civic Center Plaza (M-29) a P.O. Box 1988
Santa Ana, California 92702
www.santa-ana.oro
May 18, 2020
Matt Hyde,
Senior Vice President Sales
TSYS Merchant Solutions, LLC
2579 W. 600 N.,
Lindon, Utah 84042
A-2018-170-02
CITY MANAGER
Kristine Ridge
CITY ATTORNEY
Sonia R. Carvalho
CLERK OF THE COUNCIL
Daisy Gomez
Re: Second and Final, Extension of Fourth Amendment to Agreement (#A-2018-170) for Payment
Processing Services
Dear Matt Hyde,
Pursuant to Section One of the Fourth Amendment to Agreement No. .A-2014-071, entered into between
TSYS Merchant Solutions, LLC, formerly TransFirst, LLC, and the City of Santa Ana, dated June 19,2018,
(#A-2018-170 or "Agreement"), the term of the Agreement is hereby extended -for an additional andfinal
one (I) year period from July I, 2020 through June 30; 2021:`All other terms and conditions of the
Agreement, as amended, remain unchanged and in full force and effect.
If you have any questions regarding this matter, please contact Willard Holt, Treasury and Customer
Services Manager in the Finance and Management Services Agency at 714-647-5456.
Sincerely,
Kathryn Downs, CPA
Executive Director, Finance and Management Services Agency
CITY OF SANTA ANA
Kristine
City Manager
APPROVED AS TO FORM
ATTEST
Daisy Gomez, MMC
Clerk of the Council
TSYS MERCHANT SOLUTIONS, LLC
C � etannew l%fYAyL IL...
Lisa Storck By: Matt Hyde
Assistant City Attorney Title: Senior Vice President Sales
SANTA ANA CITY COUNCIL
",rol A pmluo Jopn V 11W., Ymd. sales mw Co. P- Aie Aoia spmno PM moor. "olds Madoaea
MCYor MaWr Pm Tom Wald! WIN Wall W."dI Word Ward
Pgalipppp[Yp1Y-11d p,0 or 'roa,dalb ma(Im QpepYlpeamaenla ins pm rpwPw.idpw a,, p,p .mppdomilt 1p�iPB o,
A-2018-170-02
CERTIFICATE OF LIABILITY INSURANCE I DATE 019.1YYYvI
an ol9mD
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 Ilia certificate holder Is an ADDITIONAL INSURED, the pollcy(les) 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(a).
PRODUCER CONTACT
NAME: Connie WIIIIIRCf
J Smith Lanier & Co. Columbus PHONE FAX
200 Brookstone Centre Parkway EArc,Ne. ExU. 706-324.6671 (AIC, Nal 706-576-5607
Suite 118 ADDRESS. cwhi(mef@jsnRlhlanier.com
Columbus GA31904 INSURERS AFFORDING COVERAGE NNCtl
INSURED
Total System Services, Inc.
Attn: Donna Weeks, Corporate Risk Ins.
One TSYS Wayy; C-4
Columbus GA 31901
II
INSURER A: Federal Insurance A++ XV 20281
UsuRER e . Great Northern Ins A++ XV 20303
INSURER C'..._-
INSURER o :
INSURER E'.
COVERAGES CERTIFICATE NUMBER: 1758927392 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 THETERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
INsrl TYPE OF INSURANCE AOOL,SU111V POLICY NUMBER '� P�OOT YYF Ph011L� IYYXP
LTR
LIMITS
A X COMMERCIAL GENERAL LIABILITY I Y I 358107N 4112019 4NN2920
EACH OCCURRLM:F S$WOD11
jr
CLAIMS -MADE 1 X OCCUR
IiIA ,M SEG (Ea uc� v nncnl S I go,"
X Conaaclual Liab
MED EXP INry one pets,,) SIb00r
PERSONAL& ADV INJURY S11X10.IM,
GEN'L AGGREGATE LIMY APPLIES PER: 'i !
GENERAL AGGREGATE :S7000.UW
PROPOLICY I JEC LOC '.
JECT X
P COh1PiOP AGO 31ncNdBU
PRODUCTS
OTHER
�Uvn l\99 Cvp 325.000000
n AUTOMOBILE LIABILITY T3560131 411MIS 4112020
!CDMIIINEDSINGLELIWT—
ILn vwmvnU ; 31.000(WO
X ANY AUTO _
BODILY INJURY (Par Pelson) S
.
ALL OWNED SCHEDULED
BODILY INJURY (Per m6dnn0 5
AUTOS 'AUTOS
NON OWNED -'.
I
PROPERTY DAMAGE 5
HIRED AUTOS AUTOS I
:lPuruvcmmni)
X I Man Can, X Hbvtl Coll
14rnr1 Pn Dvn1 ACV 51 000 Dads
A 'UMBRELLA LIAR X OCCUR 79526231 41IM19 4/112020
En. O.".1d ANCE 6:14060.000
'EXCESS LIAR - CUIM&MADE]
AGGN[GAI'E 3 ^00110000
DEO IIEILNTION
S
A 'WORKERS COMPENSATION
71715990 w12019 41UZ020
X yjfnifOR: FRII
AND EMPLOYERS'LIABILITY YIN
ANY PROPRIErOMPARTNEIVEXECUTIVE E
NIA !
I E.L EACH ACCIDENT S 1.mriw0
OFtlCERIMEMRER EXCLUDED?
'(Mandatory in N141
( i
,EL DISEASE EAEMPLOYLF'ST W.000
'Uuv JueI. undm
SCHIPTiON GF OPEIIATIONS Unl.
EL (USEASC-P000Y LIMIT 51,000000 —
I I
0ESCmPTWN OF OPERATIONS I LOCA➢ONS I VWIICLE 1ADGHD 101, AtldlUvrwl liv,wha adlvtluly, mny Uv ullosM1od 11 mor4 vPuca ie mn�bvdl
Additional Named InsuredTransFlfst Holdings Corp. a TSYS Merchant Solullons LLC
(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 fum 80-02-9779 Notice Of Ca1160118li0n To Scheduled Persons or Organizations (Except Non-paymert of Premium)
C5RT fn AT5 un1 ne0 D.. n:.r, I ATInN
6 262019
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Santa Ana
ACCORDANCE WITH THE POLICY PROVISIONS.
Risk Management Divisio
_
AUTHORIZED REPRESENTATIVE
20 Civic Plaza 4th Floor FRANCINE R. VILLAREAL
Santa Ana CA 92702
I f -p
U 1UUU-ZU14 ACUHU GUMe UKAI IVN. All flgnIS re9eWea.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
CHUB B" Liability Insurance
Endorsement
Policy Period
Effective Date
Policy Number
Insured
Name of Company
Date Issued
This Endorsement applies to the following forms:
GENERAL LIABILITY
Who Is An Insured
APRIL 1, 2019 TO APRIL 1, 2020
APRIL 1, 2019
3581-07-96 ATL
TOTAL SYSTEM SERVICES, INC.
FEDERAL INSURANCE COMPANY
APRIL 30, 2019
Under Who Is An Insured, the following provision is added.
Additional Insured - Persons or organizations shown in the Schedule are insureds; but they tiro insureds only if you are
Scheduled Person obligated pursuant to a contract or agreement to provide them with such insurance as is afforded by
Or Organization this policy.
However, the person or organization is an insured only:
if and then only to the extent the person or organization is described in the Schedule;
to the extent such contractor agreement requires the person or organization to be afforded
status as an insured;
for activities that did not occur, in whole or in pan, before the execution of the contract or
agreement and
with respect to damages, loss, cost or expense for injury or damage to which this insurance
applies.
No person or organization is an insured under this provision:
that is more specifically identified under any other provision of the Who Is An Insured
section (regardless of any limitation applicable thereto).
with respect to any assumption of liability (of another person or organization) by them in a
contract or agreement. This limitation does not apply to the liability for damages, loss, cost or
expense for injury or damage, to which this insurance applies, that the person or organization
would have in the absence of such contract or agreement.
Liability Insurance Additional Insured- Schedulad Person Or Organization
Form 80-02-2357 (AeV. 5-07) Endoreemenf
REVIEWED & APPROVED
By Risk MANAGEMENT DivisiON
FRANCINE R.
CHUBB°
Liability Endorsement
(continued)
Under Conditions, the following provision is added to the condition Mud Other Insurance,
Conditions
Other Insurance —
If you are obligated, pursuant to a contract or agreement, to provide the person or organization
Primary, Noncontributory
shown in the Schedule with primary insurance such as is afforded by this policy, then in such case
Insurance — Scheduled
this insurance is primary and we will not seek contribution from insurance available to such person
Person Or Organization
or organization,
Schedule
PERSONS OR ORGANIZATIONS THAT YOU ARE OBLIGATED, PURSUANT
TO A CONTRACT OR AGREEMENT, TO PROVIDE WITH SUCH
INSURANCE AS IS Af7ORDED BY THIS POLICY,
All other terms and conditions remain unchanged.
Authorized RopreaentatNe
REVIEWED & APPROVEI.
By Risk MANACEMENT DlvisiON
Llablllty Insurance Additional Insured- Scheduled Person Or OrgenizatPon A10 lout page
Form 80.02-2967 (neV. 5-07) Endorsement / �\ t h tl-/�A--Page 2
C H LJ B B" Liability Insurance
Endorsement
Policy Period
APRIL 1, 2019 TO APRIL 1, 2020
Effective Date
APRIL 1, 2019
Policy Number
3581-07.96ATL
Insured
TOTAL SYSTEM SERVICES, INC.
Name of Company FEDERAL INSURANCE COMPANY
Date Issued APRIL 30, 2019
This Endorsement applies to the following forms:
GENERAL LIABILITY
EMPLOYEE BENEFITS ERRORS OR OMISSIONS
STOP GAP
STOP GAP - OHIO
Under Conditions, the following provision is added to the condition titled Other Insurance,
Conditions
Other Insurance - If you WV obllgated, pursuant to a written contract or agreement, to provide the person or
Primary, Noncontributory organization described in the Schedule (that Is also included in the Who Is An Insured suction of this
Insurance - Scheduled contract) with primary insurance such us is afforded by this policy, than this insurance is primary and
Person Or Organization we will not seek contribution from insurance available to such person or orl"M zuton,
Schedule
AS REQUIRED BY WRri-rEN CONTRA(, r
REVIEWED & APPROVED
By Risk MANAGEMENT DIVISION
All other terms and conditions remain unchanged. /1.� r` n DA& 6 2an 9
FRANCINE R. VI„LLA�—REAL
Authorized Rep\resentative "--(?,.`8 -�dzi'
Liability Insurance Conditions -other Insurance - Primsm Noncontrlbutory Insurance - Scheduled Person Or Organization last page
Form e0.02-26559 (Rev. 7-09) Endorsement Page I
EH LJ BB` Policy Conditions
Endorsement
Policy Period
APRIL 1, 2019 TO APRIL 1, 2020
Effective Data
APRIL 1, 2019
Policy Number
3581-07-96 ATL
Insured
TOTAL SYSTEM SERVICES, INC.
Name of Company FEDERAL INSURANCE COMPANY
Date Issued APRIL 30, 2019
This Endorsement applies to the following forms:
COMMON POLICY CONDMONS
Under Conditions, the following condition is added,
Conditions
Notice Of Cancellation When we cancel this policy for any reason, other than non-payment of premium, we will notify
To Scheduled Persons person(s) or organization(s) shown In the Schedule at least 45 days in advance of the cancellation
Or Organizations When date.
We Cancel Any failure by us to notify such person(s) or organization(s) will not: REVIEWED & APPROVEC
By R1sk MANAGEMENT DIVISION
• impose any liability or obligation of any kind upon us; or
• invalidate such cancellation. 19
��
'FMRAINCtN tt: V t-ARFAL
Schedule
Person(s) or Organization(a): IF YOU ARE OBLIGATED, PURSUANT 'TO A WRITTEN
CONTRACT
OR AGREEMENT, TO PROVIDE PERSON(S) OR
ORGANPLATION(S)
Address: WITH NOTICE OF CANCELLATION, THEN WE WILL NOTIFY
SUCH
PERSON(S) OR ORGANIZATION(S) PROVIDED THAT WITHIN
LS
DAYS OF THE DATE WE SEND NOTICE OF CANCELLATION
TO THE
FIRST NAMED INSURED, THE FIRST NAMED INSURED OR
Notice Of Cancellation To Scheduled Persons Or OVanizatlons - 45 Days
Policy Conditions (Except Non -Payment Of Premium)
Form 90-02-9564 (Ed. 3-17) Endorsement
continued
Page 1
Conditions
(continued)
Address; PRODUCER OF RECORD PROVIDES US WITH A
SPREADSHEET
CONTAINING THE NAME, MAILING ADDRESS AND, IF
AVAILMILE ,
UMAH, ADDRESS OF THE PERSON(S) OR ORGANILATION(S).
All other terms and conditions remain unchanged.
Authorized ReproaentatNc
REVIEWED & APPROVED
By RISK MANAGEMENT D111ISION
AUG 26 019
FRAN L R. VILLAREAL
Notice Of Cencellatlon To Scheduled Perecna Or Organfzaflona - 45 Delp
Polloy Condtflons (Except NoniPeymont Of Ptemium) le8tpage
Form8402.8584(Edo 347) Endorsement Page