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PROOF OF INSURANCE (2022) CLOSEDPage 1 of 2 " DATE (MM/DD/YYYY) .4+�+0RL> CERTIFICATE OF LIABILITY INSURANCE 11/09/2021 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). Center Willis PRODUCER Watson Southeast, Inc. PHONE Wi11...... 45s Watson Cert...... eF t _2378 °' C"fAM E ..... 2 P.O.Box eBlvd 30591BAN certificatesOwillis Nashville, TN 372305191 USA lumlRCPrei eGGnonlur_rnvcRer_G KI Air INSURED Pace Payments, Inc. 40 Burton Hills Blvd., Suite 415 Nashvi'lle,TN 37215 INSURER A: National Fire Insurance Company of Hartfor 20478 INSURERS: Valley Forge Insurance Company 20508 .. ..................... INSURERC: Continental Insurance Company 35289 ... _....... .� AIG... ...................................... ..----___.__ __ _____-.-_._ ------ .....,. INSURER D : Specialty Insurance Company 26883 COVERAGES CERTIFICATE NUMBER: W22832452 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. _________ .... _______ ________---------- ......... ....__-- .... BN4R AODL SUBR POLICY EFF POLICY EXP h T � —. n •wn ,_..,,_,... TYPE nF INSI IRAN(:F ....� .....� oni ,ry u::..... ,����,nn .....,nn I I IMITS A X . COMMERCIAL GENERAL LIABILITY . X... CLAIMS -MADE OCCUR ..................______ __,_..,_,_... EACH OCCURRENCE f7AMAif li'SRENTEli PRfyMi,$ES (Ea Dcc�lrrenge,)„ MED EXP (Any one person) $ 1,000,000 $ 500 O.Oq, $ 15, 000 -. 6079506577 10/31/2021 10/31/2022PERSONAL&ADVINJURY _....... ........_ _— .................� $ 1,000,000 ---2,000,000 G'E'N'L AGGREGATE LIMIT LIES.PER:...... T APPLIES PER: GENERAL AGGREGATE $ POLICY �. J EO LOC PRODUCTS - COMP/OP AGG 2 000 000 $$... ... ,.. , OTH6�R: AUTOMOBILE LIABILITY OM�BINEDSPoI�f,GLELIMIT 4Ea as `_OAn $ 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ B OWNED SCHEDULED 6079506563 10/31/2021 10/31/2022 BODILY INJURY (Per accident) —--- —----- ......................................... $ ,„„„..... AUTOS ONLY AUTOS _ _ ' HIRED NON -OWNED PRO PROPERTYDAMAGE $ .... AUTOS ONLY AUTOS ONLY ..IPer aor4e01...............­..... ----- $ x UMBRELLA LIAB x OCCUR EXCESS LIAB CLAIMS -MADE Pl X AFTFNTI,IAI G 10,000 WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN C ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? No NIA (Mandatory in NH) " If ves, describe under A Business Personal Property Business Income EACH OCCURRENCE 6079506613 10/31/2021 10/31/2022.AGGREGATE 6079506580 10/31/2021 10/31/2022 v E�L� DISEASE - EA 6079506577 10/31/2021 10/31/2022Blanket �Blanket Limit/Ded DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) SEE ATTACHED Lh-\1= Proof of $ 10,000,0 .......... ..... 10,000,0 $ 1,000,001 $ 1,000,001 $ 1,000,001 $8,770,034/$2,500 $1,500,000 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 aP ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SR ID: 21817538 BATCH: 2303662 AGENCY CUSTOMER ID: LOC #: !" ADDITIONAL REMARKS SCHEDULE AGENCY �NAMEDINSURED Willis Towers Watson Southeast, Inc. Pace Payments, Inc. 40 Burton Hills Blvd., Suite 415 POLICY NUMBER I Nashville, TN 37215 See Page 1 CARRIER See Page 1 NAIC CODE See Page 1 EFFECTIVE DATE: See Page 1 Page 2 of 2 AUUI 1 IUNAL K;CIVIAKKZ0 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: ,Certificate of Liability Insurance _............................ ......................................... _ ........... INSURER AFFORDING COVERAGE: AIG Specialty Insurance Company NAIC#: 26883 POLICY NUMBER: 018413712 EFF DATE: 10/31/2021 EXP DATE: 10/31/2022 TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Cyber/Professional E&O Liability Limit $5,000,000 Retention 500,000 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SR ID: 21817538 BATCH: 2303662 CERT: W22832452