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Client#: 1057753 PAYMEHOL
<br />ACORDTM CERTIFICATE OF LIABILITY INSURANCE OAT07120DrrYYY)
<br />3 /0 712 01 7
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE i1OLDER. 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 be endorsed. If SUBROGATION 15 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(s).
<br />PRODUCER
<br />USI Insurance Services, LLC
<br />1715 N. Westshore Blvd. #700
<br />Tampa, FL 33607
<br />813 321-7500
<br />INSURED
<br />Paymentus Corporation
<br />13024 Ballantyne Corporate Place
<br />Suite 450
<br />CONTACT
<br />NAME:
<br />A/ON , Estb 813 321-7500 (AX Nal: 813 321-7525
<br />MAIL
<br />DRESS:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FORTHE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY
<br />REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />INSURER(5) FppO�y1NG COVERE
<br />NAIC#
<br />1 INSURER A:
<br />Covington SpeClalty Insurance C
<br />13027
<br />INSURER B:
<br />Torus National Insurance Compan
<br />25496
<br />INSURER C:
<br />Travelers Indemnity Co. of Amer
<br />25666
<br />INSURER D:
<br />Federal Insurance Company
<br />20281
<br />INSURER E:
<br />Ohio Security Insurance Company
<br />24082
<br />Charlotte, NC 28277
<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 NAMEDABOVE FORTHE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY
<br />REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY TIE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />ELUSIONS AND CONDITIONS OF SUCH
<br />POLICIES, LIMITS SHOWN MAY HAVE BEE REDUCED W PAID CLAIMS.
<br />FINER
<br />LTR
<br />TYPE OF INSURANCE
<br />AODLSUBR
<br />INSR
<br />MD
<br />POLICYEFF POLICY EXP
<br />POLICY NUMBER (MMIDDfIYVYI IMMIDD/YYYYI
<br />LIMBS
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />VBA43089500 08/09/2016 08/091201
<br />EACH OCCURRENCE
<br />$1,000,000
<br />($100,000
<br />CLAIMS -MADE [A OCCUR
<br />DAMAGEE TTp ENTED
<br />PREM IE a ocwmacce,
<br />X BI/PD Ded:500
<br />MED EXP (Any one person) 1$5,000
<br />1PERSONAL&ADV INJURY $1,000,000
<br />GENT AGGREGATE LIMIT APPLIES PER
<br />GENERAL AGGREGATE 62,000,000
<br />PRO.
<br />POLICY ❑ JECT LOC
<br />PRODUCTS -COMPIOPAGG s2,000,000
<br />OTHER
<br />$
<br />E AUTOMOBILE LIABILITYIIAS1756145941
<br />13/25/2016 03/251201
<br />ICOMBINED ISINGLE LIMIT 51,000,000
<br />X ANY AUTO
<br />BODILY INJURY (Per person) $
<br />ALL OWNED
<br />SCHEDULED
<br />BODILY INJURY (Per dormant) $
<br />AUTOS
<br />X
<br />X
<br />AUTOS
<br />NON -OWNED
<br />PROPERTY Marer $
<br />tlen0
<br />HIRED AUTOS
<br />AUTOS
<br />ararccrhDAMAGE
<br />B UMBRELLA LIAR X OCCUR 86704G163ALI D8/09/2016 08/09/201
<br />X EXCESS LII B CLAIMS -MADE
<br />DEO RETENTIONS
<br />WORKERS COMPENSATION
<br />C UBOC80861416 07/18/2016 07/1820
<br />AND EMPLOYERS'LIAeILITY YIN
<br />EACH OCCURRENCE $6,000,000
<br />AGGREGATE 66,000,000
<br />$
<br />XPER
<br />ISTATIITF FGRH
<br />MY
<br />OFFICER/MEMBER E%CLUDEOXECUTIVE ENI NIA E.L EACH ACCIDENT
<br />(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE
<br />If yes, mescnbe under
<br />DESCRIPTION OF OPERATIONS below E L. DISEASE - POLICY LIMIT
<br />* Prof & Cyber Various 08/09/2016 08/09/201J $25,000,000
<br />D Crime 82368980 08/09/2016 08/09/201 See Below
<br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space is required)
<br />*Professional & Excess Professional & Cyber Liability:
<br />Policy #017012365 - Carrier: National Union Fire Ins - Effective 8/9/2016-2017 - Limit: $5,000,000
<br />Policy #MTE004184203 - Carrier: Greenwich Insurance Co. - Effective 8/912016-2017 - Limit: $5,000,000
<br />Policy #EAN79002710112016 - Carrier: Axis Insurance Co. - Effective 8/9/2016-2017 - Limit: $5,000,000
<br />Policy #EMU126512 - Carrier: Hudson Specialty Insurance Co. - Effective 8/9/2016-2017- Limit: $5,000,000
<br />(See Attached Descriptions)
<br />CERTIFICATE HOLDER CANCELLATION
<br />$1,000,000
<br />$1,000,000
<br />$1,000,000
<br />Cit of Redwood Cit SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Y y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />1017 Middlefield Road ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Redwood City, CA 94063
<br />AUTHORIZED REPRESENTATIVE
<br />C'�1'1}Ir
<br />I
<br />© 1988-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) 1 of 2 The ACORD name and logo are registered marks of ACORD
<br />#S20011731/M18422915 BXAEW
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