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TSYS MERCHANT SOLUTIONS, LLC
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Last modified
6/27/2019 8:43:44 AM
Creation date
8/1/2018 12:09:03 PM
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Contracts
Company Name
TSYS MERCHANT SOLUTIONS, LLC
Contract #
A-2018-170
Agency
FINANCE & MANAGEMENT SERVICES
Council Approval Date
6/19/2018
Expiration Date
6/30/2019
Insurance Exp Date
4/1/2020
Destruction Year
2024
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'llk� " CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DO/YYYY1 <br />3/27/2019 <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 be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms andldconditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate hoer in lieu of such endorsement(s). <br />PRODUCER <br />J Smith Lanier & Co. Columbus <br />200 Brookstone Centre Parkway <br />Suite 118 <br />Columbus GA 31904 <br />CONTACT <br />NAME: Connie Whitmer <br />PHONE EMI 706-324-6671FAI <br />ac No 706-576-5607 <br />EMAIL <br />ADOREss: ewhitmer ismithlanieccom <br />INSURERS AFFORDING COVERAGE <br />NAIC% <br />INSURED 30TOTALSYSTE <br />Total System Services, Inc. <br />Attn: Donna Weeks, Corporate Risk Ins, <br />One Donna <br />Way; C-4 <br />Columbus GA 31901 <br />INSURER A: Fedefal lnSUfanCe <br />INSURER B: Great Northern Insurance A++XV <br />20281 <br />20303 <br />INSURERC: <br />INSURER 0: <br />INSURER E : <br />INSURER F <br />COVERAGES CFGTICId`ATIC KIN m.rIl- <br />-_..... REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE PnI Irir=c n. r. <br />—--•—•-- � ����.+�.�.� uolcu DELUVV HAVE BEEN <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY <br />ISSUED TO <br />CONTRACT <br />THE INSURED <br />NAMED ABOVE FOR <br />THE POLICY PERIOD <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED <br />OR OTHER <br />DOCUMENT WITH RESPECT <br />TO WHICH THIS <br />BY <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN <br />THE POLICIES <br />DESCRIBED <br />HEREIN IS SUBJECT TO <br />ALL THE TERMS, <br />INSR <br />REDUCED BY <br />PAID CLAIMS. <br />LTft ADDLSUBR TYPE OF INSURANCE POLICY NUMBER <br />POLICY EFF <br />POLICY E%P <br />A X COMMERCIAL GENERAL LIABILITY Y 350107M <br />MM/112019 Y <br />MM/10020 Y <br />LIMITS <br />4/1/2019 <br />4/12020 <br />EACH OCCURRENCE <br />E 1 000,000 <br />CLAIMS -MADE IE OCCUR <br />DAMAGE TO RENTED <br />X Contractual Liao <br />PR MISES Eaoccunance <br />E1,000,000 <br />MED EXP (Any ona arson) <br />g 15,000 <br />PERSONAL&AOV INJURY <br />$1.000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER' <br />GENERAL AGGREGATE <br />E2,000,n00 <br />POLICY ❑ JECT I LOC <br />PRODUCTS - COMP/OP AGO <br />$lnduded <br />OTHER : <br />Gen Ag Ca <br />Gen <br />S25,000.0W <br />B AUTOMOBILE LIABILITY <br />4/12019 <br />4/1/2020 <br />COMBINED SINGLE LIMIT <br />Ea..denl <br />$ 000000 <br />X ANY AUTO <br />BODILY INJURY (Per person) <br />S <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />HIREDAUTOS NON -OWNED <br />AUTOS <br />PeroPERTY DAMAGE <br />X XHiretl Coll <br />Com <br />-acaden <br />S <br />Hired Phy Dam -ACV <br />E 14DW Dods <br />UMB <br />A X UMBRELLA LIAB X OCCUR 79825231 <br />EXCESS LIAB <br />411=19 <br />4/1/2020 <br />EACH OCCURRENCE <br />E25,000,000 <br />AGGREGATE <br />S25.000.000 <br />CLAIMS -MADE <br />DED RETENTIONS <br />A WORKERS COMPENSATION 71715993 <br />PER <br />a <br />AND <br />YIN <br />4/12019 <br />4/l/2020 <br />OTH- <br />X STATUTE ER <br />ROPRIEERS'RTNELIABILITY <br />PROPRIETOR/ <br />OFFICEANY <br />REXCLUOE07 ❑N/A <br />EXCLUDED? <br />E. L. EACH ACCIDENT <br />E1.000,000 <br />(Mandatory In N <br />It ory In NH) <br />E.L. DISEASE - EA EMPLOYE <br />E 1,000,000 <br />yes. d <br />If yes, tlescnbe under <br />DESCRIPTION OF OPERATIONS below <br />E.LDISEASE -POLICY LIMIT <br />81.000,000 <br />DESCRIPTION OF OPERATIONS [LOCATIONS / VEHICLES (ACORD 101, Addidonal Remarks Schedule, may ba allachatl a more space is required) <br />Additional Named Insured: TransF1rst Holdings Corp. & <br />TSYS Merchant Solutions LLC <br />(GL) Additional Insured per farm: 80-02-2367 Additional Insured Scheduled Person or Organization <br />(GL) Primary and Noncontributory pe <br />Organization r form: 80-02-2653 Conditions — Other Insurance — Primary, Noncontributory Insurance Scheduled Person or <br />`/-zs-Z©%9 <br />� � <br />r:FQTIFIr.ATF Hnl nco <br />City of Santa Ana <br />20 Civic Plaza <br />Santa Ana CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />© 1988-2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD <br />
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