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Client#: 675030 GLOBAPAYME
<br /> ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDlYYYY)
<br /> 3/2612025
<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 have ADDITIONAL INSURED provisions or be endorsed,
<br /> If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on
<br /> this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT Allison Peak
<br /> - -
<br /> Marsh &McLennan Agency LLC PHONE FAX
<br /> 200 Brookstone Centre Pkwy
<br /> (AC,
<br /> No,Ext),706-324-6671 ..I.(A/c,No: 706-576-5607
<br /> ai AILss: Allison.Peak@MarshMMA.com
<br /> Suite 118
<br /> RE
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> Columbus, GA 31904 !INSURER A:Federal Insurance Company A++XV 20281
<br /> INSURED 22667
<br /> INSURER B:ACE American Insurance Company A++XV
<br /> TSYS Merchant Solutions, LLC -
<br /> Attention: Devery Gauthier INSURER C:
<br /> 3550 Lenox Road NE,Suite 3000 INSU REP n
<br /> Atlanta, GA 30326 INSURER E
<br /> INSURER F
<br /> COVERAGES CERTIFICATE NUMBER: 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 /> INSR ADDLSUBR.
<br /> LTR_ TYPE OF INSURANCE INSR WVD POLICY NUMBER MMIDDfYY MMIDD;YYY LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY 36048071 4/0112025 04/0112026 EACH OCCURRENCE _ $1,0()O OOO
<br /> CLAIMS-MADE OCCUR DAMAGE TO RENTED
<br /> PREMISES(Ea occurrence) $1,000,000
<br /> MED EXP(Any cne person) $1 MOO
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GENT AGGREGATE LIMIT APPLFIESPER: GENERAL AGGREGATE $2,000,000
<br /> POLI
<br /> CYDX
<br /> PRO- X
<br /> ECT ^ LOC PRODUCTS-COMPICPAGG $2,000,000
<br /> OTHER Gen Agg Cap $100,000,000
<br /> A AUTOMOBILE LIABILITY 73614277 4101/2025 04101/2026 CM
<br /> Ea aBciae°tsmGLE UNIT 51,000,000 _
<br /> xANY AUTOBODILY INJURY(Per person) $
<br /> OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> X AUTOS ONLY AUTOS ONLY Per accident $
<br /> $
<br /> A X UMBRELLA LIAB X OCCUR 79894591 4/01/2025 04/01/202 EACH OCCURRENCE $25 000 OOO
<br /> EXCESS LIAR CLAIMS-MADE AGGREGATE 125,000,000
<br /> I
<br /> I DED RETENTION$
<br /> $
<br /> B WORKE IRS COM PEN SATION 71750292 4/01/2025 04/01/202 X
<br /> AND EMPLOYERS'LIABILITY YIN PTALUTE OTH-
<br /> A ANY PROPRIETOR)PARTNERIEXECUTIVE 71750293 4/0112025 0410112026 EL EACH ACCIDENT $1 000 000
<br /> OFFICERIMEMBER EXCLUDED? C NIA _ ,
<br /> ;(Mandatory in NH) FL DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $1,000,000
<br /> A Hired Auto 73614277 4/0112025 04/0112026 Actual Cash Value
<br /> Physical Damage $1,000 Comp Ded.
<br /> $1,000 Coll Ded.
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> First Named Insured: Global Payments Inc.& It's Subsidiaries
<br /> APPROVED
<br /> City of Santa Ana City, its officers,employees, agents, volunteers and representatives By Tu Tran Nguyen at4:2S pm,May 14,2025
<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, Tu Tran TuTran Ngwy d
<br /> 7u Tran Nguyen
<br /> (See Attached Descriptions) oate:zozs.os.,a
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 20 Civic Plaza 4th Floor
<br /> Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE
<br /> O 1988-2015 ACORD CORPORATION.All rights reserved.
<br /> ACORD 25(2016103) 1 of 2 The ACORD name and logo are registered marks of ACORD
<br /> #S148889231M 14888474 J LMA P
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