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A-2018-170-02 <br />CERTIFICATE OF LIABILITY INSURANCE I DATE 019.1YYYvI <br />an ol9mD <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 Ilia certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be 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 certificate does not confer rights to the <br />certificate holder In lieu of such endorsement(a). <br />PRODUCER CONTACT <br />NAME: Connie WIIIIIRCf <br />J Smith Lanier & Co. Columbus PHONE FAX <br />200 Brookstone Centre Parkway EArc,Ne. ExU. 706-324.6671 (AIC, Nal 706-576-5607 <br />Suite 118 ADDRESS. cwhi(mef@jsnRlhlanier.com <br />Columbus GA31904 INSURERS AFFORDING COVERAGE NNCtl <br />INSURED <br />Total System Services, Inc. <br />Attn: Donna Weeks, Corporate Risk Ins. <br />One TSYS Wayy; C-4 <br />Columbus GA 31901 <br />II <br />INSURER A: Federal Insurance A++ XV 20281 <br />UsuRER e . Great Northern Ins A++ XV 20303 <br />INSURER C'..._- <br />INSURER o : <br />INSURER E'. <br />COVERAGES CERTIFICATE NUMBER: 1758927392 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 <br />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 THETERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />INsrl TYPE OF INSURANCE AOOL,SU111V POLICY NUMBER '� P�OOT YYF Ph011L� IYYXP <br />LTR <br />LIMITS <br />A X COMMERCIAL GENERAL LIABILITY I Y I 358107N 4112019 4NN2920 <br />EACH OCCURRLM:F S$WOD11 <br />jr <br />CLAIMS -MADE 1 X OCCUR <br />IiIA ,M SEG (Ea uc� v nncnl S I go," <br />X Conaaclual Liab <br />MED EXP INry one pets,,) SIb00r <br />PERSONAL& ADV INJURY S11X10.IM, <br />GEN'L AGGREGATE LIMY APPLIES PER: 'i ! <br />GENERAL AGGREGATE :S7000.UW <br />PROPOLICY I JEC LOC '. <br />JECT X <br />P COh1PiOP AGO 31ncNdBU <br />PRODUCTS <br />OTHER <br />�Uvn l\99 Cvp 325.000000 <br />n AUTOMOBILE LIABILITY T3560131 411MIS 4112020 <br />!CDMIIINEDSINGLELIWT— <br />ILn vwmvnU ; 31.000(WO <br />X ANY AUTO _ <br />BODILY INJURY (Par Pelson) S <br />. <br />ALL OWNED SCHEDULED <br />BODILY INJURY (Per m6dnn0 5 <br />AUTOS 'AUTOS <br />NON OWNED -'. <br />I <br />PROPERTY DAMAGE 5 <br />HIRED AUTOS AUTOS I <br />:lPuruvcmmni) <br />X I Man Can, X Hbvtl Coll <br />14rnr1 Pn Dvn1 ACV 51 000 Dads <br />A 'UMBRELLA LIAR X OCCUR 79526231 41IM19 4/112020 <br />En. O.".1d ANCE 6:14060.000 <br />'EXCESS LIAR - CUIM&MADE] <br />AGGN[GAI'E 3 ^00110000 <br />DEO IIEILNTION <br />S <br />A 'WORKERS COMPENSATION <br />71715990 w12019 41UZ020 <br />X yjfnifOR: FRII <br />AND EMPLOYERS'LIABILITY YIN <br />ANY PROPRIErOMPARTNEIVEXECUTIVE E <br />NIA ! <br />I E.L EACH ACCIDENT S 1.mriw0 <br />OFtlCERIMEMRER EXCLUDED? <br />'(Mandatory in N141 <br />( i <br />,EL DISEASE EAEMPLOYLF'ST W.000 <br />'Uuv JueI. undm <br />SCHIPTiON GF OPEIIATIONS Unl. <br />EL (USEASC-P000Y LIMIT 51,000000 — <br />I I <br />0ESCmPTWN OF OPERATIONS I LOCA➢ONS I VWIICLE 1ADGHD 101, AtldlUvrwl liv,wha adlvtluly, mny Uv ullosM1od 11 mor4 vPuca ie mn�bvdl <br />Additional Named InsuredTransFlfst Holdings Corp. a TSYS Merchant Solullons LLC <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, Noncontributory Insurance Scheduled Person or <br />Organization <br />(GL) 45 Day Notice of Cancellation per fum 80-02-9779 Notice Of Ca1160118li0n To Scheduled Persons or Organizations (Except Non-paymert of Premium) <br />C5RT fn AT5 un1 ne0 D.. n:.r, I ATInN <br />6 262019 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Ana <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Risk Management Divisio <br />_ <br />AUTHORIZED REPRESENTATIVE <br />20 Civic Plaza 4th Floor FRANCINE R. VILLAREAL <br />Santa Ana CA 92702 <br />I f -p <br />U 1UUU-ZU14 ACUHU GUMe UKAI IVN. All flgnIS re9eWea. <br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD <br />