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natly sned by Ton Pin Tori Pierson DeMa)22M.2noe.2z53 Was' A� O® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIT022 Y) 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 the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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(s). PRODUCER Marsh & McLennan Agency, LLC 2000 Brookstone Centre Pkwy Suite 118 Columbus GA 31904 CONTACT NAME Connie Whitmer PHONE FAx - 706-324-6671 AIX .1706 -576-5607 MAIL ADDRESS: Connie.Whitmer MarshMMA.Com INSURERS AFFORDING COVERAGE NAIC# wsURERA: Federal Insurance Company A++XV 20281 INSURED 3DGLOBALPAYM TSYS Merchant Solutions LLC Global Payments, Inc. & It's Subsidiaries INSURER B : Great Northern Insurance Company A++XV 20303 INSURER c: ACE American Insurance Company A++XV 22667 INSURER D One TSYS Way; C-4 Columbus GA 31901 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 652492694 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 THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR rypE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIODNM LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE1XI OCCUR V W049071 4/112022 V112023 EACH OCCURRENCE $1=000 DAMAGE(RENTED PREMISESSEa occurrence) $1000,000 MED EXP (Any one person) $10,000 PERSONAL &ADV INJURY $10D00D0 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY JE� LOC GENERAL AGGREGATE $2.001 PRODUCTS - COMPIOPAGG $1000000 1 Gen Agg Cap $100000,000 OTHER B AUTOMOBILE LIABILITY 736142T 4/1/2022 4112023 COMBINED SINGLE LIMIT Ea accident $1000 00 BODILY INJURY (Per person) $ %( ANY AUTO ALLOWNEO SCHEDULED AUTOS AUTOS BODILY INJURY ( Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident) $ Hired Phy Col -ACV $TOM Dal. X Hired Con, X Hired Coll A X UMBRELLA LIAB OCCUR - 79894591 _ 4112022 4/12023 EACH OCCURRENCE $25,D00,000 AGGREGATE $25,000,000 EXCESS LIAB CLAIMS -MADE DIEDRETENTION$ $ C A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN 71750292 71750293 - 4112022 4112022 4/1/2023 4/1/2023 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $1000,000 ANY PROPRIETOWPARTNEWEXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? NIA E.L. DISEASE - EA EMPLOYEE $1.000000 (Mandatary In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1.000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) City of Santa Ana City, its officers, employees, agents, volunteers and representatives (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 form: 80-02-9779 Notice of Cancellation To Scheduled Persons or Organizations (Except Non-payment of Premium) City of Santa Ana Risk Management Division 20 Civic Plaza 4th Floor Santa Ana CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. - AUTHORIZED REPRESENTATIVE e.y� RWrMmgeagt Diiipr %du ;)&wde V 110ee-ZU14 ALUKU LA ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD