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HomeMy WebLinkAboutInsurance Certificate: Global Payments Inc. (2) Page 1 of 1 at, DATE(MM/DD/YYYY) ACCCO CERTIFICATE OF LIABILITY INSURANCE 05/30/2019 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 have ADDITIONAL INSURED provisions or 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 CONTACT NAME: Willis Insurance Services of Georgia, Inc PHONE ,FAX c/o 26 Century Blvd IA/CNo, x. 1-877-945-7378 A/C No: 1-686-467-2378 E-MA P.O Box 305191 A DRIESS: certificates@willis.com Nashville, TN 372305191 USA INSURER(S) AFFORDING COVERAGE NAIC# INSURERA. Phoenix Insurance Company 25623 INSURED INSURERB. Travelers Indemnity Company of America 25666 Global Payments Inc. and its' Subsidiaries OpenEdge Payments LLC INSURER C. Charter Oak Fire Insurance Company 25615 3550 Lenox Road NE, Suite 3000 INSURER D. Atlanta, GA 30326 INSURER E. INSURER F COVERAGES CERTIFICATE NUMBER: W11443950 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 TYPE OF INSURANCE ADD 1 WVD , POLICY NUMBER MM DD/YYYY MM INSD LTR / D/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 1,000,000 CLAIMS-MADE OCCUR PREMISES (Ea occurrence $ LXI A MED EXP (Any one person) $ 10 , 000 HN 660 15BD7542-PHX-19 06/01/2019 06/01/2020jPERSONAL&ADVINJURY $ 1,000,000 u GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 ^ POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 ~ I OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident' ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS I-~ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE'. AGGREGATE $ DED li RETENTIONS $ !WO KERSCOMPENSATION X PER OTH- I AND EMPLOYERS' LIABILITY STATUTE ER Y/N 1,000,000 B ANYPROPRIETOR/PARTNER/EXECUTIVE F-1 E.L. EACH ACCIDENT $ (OFFICER/MEMBEREXCLUDED' N/A' HC2HUB-2333L41-5-19 i06/Ol/2019~06/O1/2020 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ C (Workers' Compensation and HROUB-118D8912-19 06/01/2019106/01/2020 Each Accident $1,000,000 ';Employers Liability - Disease-Policy Limit 1$1,000,000 Per Statute (Disease-Each Employe $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space is required) City of Ashland, Oregon and it's elected officials, officers and employees are Additional Insureds where required by written contract- CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland AUTHORIZED REPRESENTATIVE Attn: Kariann Olson 90 N Mountain Avenue lln in/' Ashland, OR 97520 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD sR ID 18036659 aATcH 1221175 DATE-(MM/DD/YYYY( 08/301201s AFRO CERTIFICATE OF LIABILITY INSURANCE 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 have ADDITIONAL INSURED provisions or 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). d PRODUCER CONTACT NAME Aon Risk Services South, Inc. PHONE FAX Atlanta GA Office (A/c. No. EIit) (866) 281 7127 (aC. No.). (800) 363-0101 v 3550 Lenox Road NE E-MAIL x suite 1700 ADDRESS Atlanta GA 30326 USA INSURER(S) AFFORDING COVERAGE NAIC lI INSURED INSURERA. XL Specialty Insurance CO 37885 Global Payments Inc & Subsidiaries INSURER B. Lloyd's Syndicate No. 4711 AA1120090 3550 Lenox Rd NE, Ste 3000Atlanta GA 30326 USA INSURER C INSURER D INSURER E'. INSURER F COVERAGES CERTIFICATE NUMBER: 570078095888 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 Limits shown are as requested INSR ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MMIDDIYVYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS-MADE ❑ OCCUR PREM SESOIEa accur2nce) MED EXP (Any one person, PERSONAL &AOV INJURY m GEN'L AGGREGATE LIMIT APPLIES PER GENERALAGGREGATE PRO l~ m POLICY F-~ JECT I I LOC PRODUCTS - COMPIOP AGG - IL~~ o 0 OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY I Per person 0 OWNED AUTOS SCHEDULED BODILY INJURY (Per accident, z W ONLY AUTOS PROPERTY DAMAGE ~ HIRED AUTOV NON OWNED (Per accldentl fw ONLI AUTOS CNLI d U UMBRELLA LIAR OCCUR EACH OCCURRENCE I CLAIMS-MADE AGGREGATE E%CE53 LIAR H DED RETENTION WORKERS COMPENSATION AND I STATUTE OEUH EMPLOYERS' LIABILITY N l ' ANV PROPRIETOR /PARTNER/ EXECUrIVE E~ EACH ACCIDENT OFFICER/MEMBER EXCLUDED" N I A (Mandatoryin NH) EL DISEASE-EA EMPLOYEE It yes, describe under DESCRIPTION OF OPERATIONS below E L DISEASEPOLICY LIMIT A cyber Liability E09/01/2018 12/01/2019 Limit $10,000,000 - E&O - Cyber Liability SIR applies per policy ter s & condi ions DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES iACORD 101. Additional Remarks Schedule, may too attached d more space,, requiedl Evidence of Coverage L CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE. DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS _ Global Payments, Inc. AUTHORIZED REPRESENTATIVE p~ 3550 Lenox Road, suite 2600 Atlanta GA 30326 USA ©1988-2015 ACORD CORPORATION. All rights reserved ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000075610 LOC A~RO~ ADDITIONAL REMARKS SCHEDULE Page _ of _ 'GIN- NAMED 'NSUREG Aon Risk Services South, Inc. Global Payments Inc & Subsidiaries POLICY NUMBER SPP rPrtifiratP NumhPr• 570078095888 CARRIER NAIC CODE See certificate Number: 570078095888 EPFECTIVE DATE ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # I INSURER I\SURER INSURER INSURER ADDITIONAL POLICIES Ita policy heloW does not include limit Information- reter to the corresponding pollc% on the ACORD certificate form for pollee limits P(11.1('1' POLIO) (NSR ADDL St 'DR r\P1: OF INSI. RAN(' E POIA('\'N(MDE:R EFFF.("1'1%E: DATE E\PIRAI[ON LIMITS LTR INSD WVD (MM/DD/VVVN) DATE' OTHER B Cyber Liab-x5 FSCE01801611 09/01/2018 12/01/2019 Limit $10,000,000 ACORD 101 (2008101) c: 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. XTEND ENDORSEMENT FOR TECHNOLOGY - GLOBAL PAYMENTS, INC. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE - This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general coverage description only. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Non-Owned Watercraft- 75 Feet Long Or Less H. Blanket Additional Insured - Governmental B. Who Is An Insured - Employees - Supervisory Entities - Permits Or Authorizations Relating To Positions Premises C. Who Is An Insured - Liability For Conduct Of I. Blanket Additional Insured - Governmental Unnamed Partnerships Or Joint Ventures Entities - Permits Or Authorizations Relating To D. Blanket Additional Insured - Persons Or Operations Organizations For Your Ongoing Operations As J. Medical Payments - Increased Limit Required By Written Contract Or Agreement K. Blanket Waiver Of Subrogation E. Blanket Additional Insured - Broad Form Vendors F. Blanket Additional Insured -Controlling Interest L. Contractual Liability - Railroads M. Damage To Premises Rented To You G. Blanket Additional Insured - Mortgagees, Assignees, Successors Or Receivers e. Any person or organization that, with your PROVISIONS express or implied consent, either uses or is responsible for the use of a watercraft A. NON-OWNED WATERCRAFT - 75 FEET LONG that you do not own that is: OR LESS 1. The following replaces Paragraph (2) of (1) 75 feet long or less, and Exclusion g., Aircraft, Auto Or Watercraft, of SECTION I - (2) Not being used to carry any person or in Paragraph 2. COVERAGES - COVERAGE A - BODILY property for a charge. INJURY AND PROPERTY DAMAGE B. WHO IS AN INSURED - EMPLOYEES - LIABILITY: SUPERVISORY POSITIONS (2) A watercraft you do not own that is: The following is added to Paragraph 2.a.(1) of SECTION II - WHO IS AN INSURED: (a) 75 feet long or less; and Paragraphs (1)(a), (b) and (c) above do not apply (b) Not being used to carry any person or to "bodily injury" to a co-"employee" while in the property for a charge, course of the co-"employee's" employment by you 2. The following replaces Paragraph 2.e. of arising out of work by any of your "employees" SECTION II - WHO IS AN INSURED: who hold a supervisory position. CG T8 03 20179 The Travelers Indemnity Company All rights reserved. Page 1 of 4 Includes copyriontea rnatenal of insurance Services Office, inc- w th its permission COMMERCIAL GENERAL LIABILITY C. WHO IS AN INSURED - LIABILITY FOR b. Arises out of "your products" that are CONDUCT OF UNNAMED PARTNERSHIPS OR distributed or sold in the regular course of JOINT VENTURES such vendor's business. The following replaces the last paragraph of The insurance provided to such vendor is subject SECTION II - WHO IS AN INSURED: to the following provisions: No person or organization is an insured with a. The limits of insurance provided to such respect to the conduct of any current or past vendor will be the minimum limits that you partnership or joint venture that is not shown as a agreed to provide in the written contract or Named Insured in the Declarations. This agreement, or the limits shown in the paragraph does not apply to any such partnership Declarations, whichever are less. or joint venture that otherwise qualifies as an b. The insurance provided to such vendor does insured under Section II - Who Is An Insured. not apply to: D. BLANKET ADDITIONAL INSURED - PERSONS OR ORGANIZATIONS FOR YOUR ONGOING (1) Any express warranty not authorized by OPERATIONS AS REQUIRED BY WRITTEN you or any distribution or sale for a CONTRACT OR AGREEMENT purpose not authorized by you, The following is added to SECTION II - WHO IS (2) Any change in "your products" made by AN INSURED: such vendor; Any person or organization that is not otherwise (3) Repackaging, unless unpacked solely for an insured under this Coverage Part and that you the purpose of inspection, demonstration, have agreed in a written contract or agreement to testing, or the substitution of parts under include as an additional insured on this Coverage instructions from the manufacturer, and Part is an insured, but only with respect to liability then repackaged in the original container, for "bodily injury" or "property damage" that: (4) Any failure to make such inspections, a. Occurs subsequent to the signing of that adjustments, tests or servicing as contract or agreement; and vendors agree to perform or normally b. Is caused, in whole or in part, by your acts or undertake to perform in the regular omissions in the performance of your ongoing course of business, in connection with the operations to which that contract or distribution or sale of "your products agreement applies or the acts or omissions of (5) Demonstration, installation, servicing or any person or organization performing such repair operations, except such operations operations on your behalf. performed at such vendor's premises in connection with the sale of "your The limits of insurance provided to such insured products"; or will be the minimum limits that you agreed to provide in the written contract or agreement, or (6) "Your products" that, after distribution or the limits shown in the Declarations, whichever sale by you, have been labeled or are less. relabeled or used as a container, part or E. BLANKET ADDITIONAL INSURED - BROAD Ingredient of any other thing or substance FORM VENDORS by or on behalf of such vendor. The following is added to SECTION 11 - WHO IS Coverage under this provision does not apply to AN INSURED: a. Any person or organization from whom you Any person or organization that is a vendor and have acquired "your products", or any that you have agreed in a written contract or ingredient, part or container entering into.. agreement to include as an additional insured on accompanying or containing such products, this Coverage Part is an insured, but only with or respect to liability for "bodily injury" or "property b. Any vendor for which coverage as an damage" that: additional insured specifically is scheduled by a. Occurs subsequent to the signing of that endorsement. contract or agreement; and F. BLANKET ADDITIONAL INSURED - CONTROLLING INTEREST Page 2 of 4 J 20'9 The Travelers tndemn ty C:ompany. All rights reservers T8 D3 Incluees copyrighted material of Insurance Services Office, Inc Nith is eermissio COMMERCIAL GENERAL LIABILITY 1. The following is added to SECTION II - WHO provide in the written contract or agreement. IS AN INSURED- or the limits shown in the Declarations, Any person or organization that has financial whichever are less. control of you is an insured with respect to b. The insurance provided to such person or liability for "bodily injury", "property damage" organization does not apply to. or "personal and advertising injury" that arises (1) Any "bodily injury" or "property damage" out of: that occurs, or any "personal and a. Such financial control; or advertising injury" caused by an offense b. Such person's or organization's that is committed, after such contract or ownership, maintenance or use of agreement is no longer in effect; or premises leased to or occupied by you. (2) Any "bodily injury", "property damage" or The insurance provided to such person or "personal and advertising injury" arising organization does not apply to structural out of any structural alterations, new alterations, new construction or demolition construction or demolition operations operations performed by or on behalf of such performed by or on behalf of such person or organization. mort gagee, assignee, successor or receiver 2. The following is added to Paragraph 4. of SECTION II -WHO IS AN INSURED: H. BLANKET ADDITIONAL INSURED - GOVERNMENTAL ENTITIES - PERMITS OR This paragraph does not apply to any AUTHORIZATIONS RELATING TO PREMISES premises owner, manager or lessor that has The following is added to SECTION II - WHO IS financial control of you. AN INSURED: G. BLANKET ADDITIONAL INSURED - MORTGAGEES, ASSIGNEES, SUCCESSORS Any governmental entity that has issued a permit OR RECEIVERS or authorization with respect to premises owned or occupied by, or rented or loaned to, you and The following is added to SECTION II - WHO IS that you are required by any ordinance, law, AN INSURED: building code or written contract or agreement to Any person or organization that is a mortgagee, include as an additional insured on this Coverage assignee, successor or receiver and that you Part is an insured, but only with respect to liability have agreed in a written contract or agreement to for "bodily injury", "property damage" or "personal include as an additional insured on this Coverage and advertising injury" arising out of the Part is an insured, but only with respect to its existence, ownership, use, maintenance, repair, liability as mortgagee, assignee, successor or construction, erection or removal of any of the receiver for "bodily injury", "property damage" or following for which that governmental entity has "personal and' advertising injury" that: issued such permit or authorization- advertising a. Is "bodily injury" or "property damage" that signs, awnings, canopies, cellar entrances, coal occurs, or is "personal and advertising injury" holes, driveways, manholes, marquees, hoist caused by an offense that is committed, away openings, sidewalk vaults, elevators, street subsequent to the signing of that contract or banners or decorations. agreement; and I. BLANKET ADDITIONAL INSURED - b. Arises out of the ownership, maintenance or GOVERNMENTAL ENTITIES - PERMITS OR use of the premises for which that mortgagee, AUTHORIZATIONS RELATING TO OPER- assignee, successor or receiver is required ATIONS under that contract or agreement to be The following is added to SECTION II - WHO IS Included as an additional insured on this AN INSURED: Coverage Part. Any governmental entity that has issued a permit The insurance provided to such mortgagee, or authorization with respect to operations assignee, successor or receiver is subject to the performed by you or on your behalf and that you following provisions: are required by any ordinance, law, building code a. The limits of insurance provided to such or written contract or agreement to include as an mortgagee, assignee, successor or receiver additional insured on this Coverage Part is an will be the minimum limits that you agreed to insured, but only with respect to liability for "bodily C,~ 20179 Tne. Travelers Indemnity comoany All rights reserved Page 3 of 4 includes copyrighted rnaterial of Insurance Services Office, Inc. w,th is perrmssion CG T8 03 COMMERCIAL GENERAL LIABILITY injury", "property damage" or "personal and recovery against any person or organization, we advertising injury" arising out of such operations. waive our right of recovery against such person or The insurance provided to such governmental organization, but only for payments we make because of: entity does not apply to: a. Any "bodily injury", "property damage" or a. "Bodily injury" or "property damage" that "personal and advertising injury" arising out of occurs; or operations performed for the governmental b. "Personal and advertising injury" caused by entity; or an offense that is committed; b. Any "bodily injury" or "property damage" subsequent to the execution of the contract or included in the "products-completed agreement. operations hazard'". L. CONTRACTUAL LIABILITY - RAILROADS J. MEDICAL PAYMENTS - INCREASED LIMIT 1. The following replaces Paragraph c. of the The following replaces Paragraph 7. of SECTION definition of "insured contract" in the III - LIMITS OF INSURANCE: DEFINITIONS Section_ 7. Subject to Paragraph 5. above, the Medical c. Any easement or license agreement; Expense Limit is the most we will pay under 2. Paragraph f.(1) of the definition of "insured Coverage C for all medical expenses contract" in the DEFINITIONS Section is because of "bodily injury" sustained by any deleted. one person, and will be the higher of: M. DAMAGE TO PREMISES RENTED TO YOU a. $10,000; or The following replaces the definition of "premises b. The amount shown in the Declarations of damage" in the DEFINITIONS Section: this Coverage Part for Medical Expense Limit. "Premises damage" means "property damage" to: K. BLANKET WAIVER OF SUBROGATION a. Any premises while rented to you or The following is added to Paragraph 8., Transfer temporarily occupied by you with permission Of Rights Of Recovery Against Others To Us, of the owner; or of SECTION IV - COMMERCIAL GENERAL b. The contents of any premises while such LIABILITY CONDITIONS: premises is rented to you, if you rent such If the insured has agreed in a contract or premises for a period of seven or fewer agreement to waive that insured's right of consecutive days. Reterence:TM01236 Page 4 of 4 © 20"9 The Travelers Incemnity Company AI' rights reserved. CG T8 03 Includes copyrighted materai of Insurance Services Office, Inc. wi'.h its permission