Client#: 68158
ACORD„
HEAPA3
DATE(MM/OD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
10/02/2015
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 poiicy(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).
Judy Post
PRODUCER
People's United Ins. Agency CT
CSgt..™:860 524-7663
One Goodwin Square
Hartford, CT 06103
ADc^Ess: judy.post@peoples.eom
860 524-7600
INSURER A: Haitford Fire Insurance Company
INSURER B: Hartford Casualty Insurance Com
INSURER(S) AFFORDING COVERAGE
INSURED
TouchNet Information Systems, Inc
(Heartland Payment Systems, Inc.)
NAIC»
19682
29424
27120
INSURER c: Trumbull Insurance Company
INSURER D: Nat'l Uolon Fire Ins. Co of Pit
15520 College Boulevard
Lenexa, KS 66219
19445
INSURER E:
INSURER F:
COVERAGES
CERTIFICATE NUMBER:- — ^
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
A
ADDL SUBR
TYPE OF INSURANCE
X
COMMERCIAL GE NERAL UABILITY
CLAIMS-MAC
POLICY EFF
POLICY NUMBER
INSR WVD
02UUNTD0886
POLICY EXP
10/01/2015 10/01/201C
GEN'L AGGREGATE LIMIT APPLIES PER:
1
1 PRO-
1 JECT
$1,000,006
EACH OCCURRENCE
DAMAGETORENTED
E 1 X|OCCUR
POLICY 1
LIMITS
(MM/DD/YYYYl (MM/DD/YYYY]
X LOG
PREMISES(Ea occurrence)
$300,000
MED EXP(Any one person)
$10,000
PERSONAL & ADV INJURY
$1,000,000
GENERAL AGGREGATE
$2,000,000
PRODUCTS - COMP/OP AGG
A
AUTOMOBILE LIABILITY
X
02UUNTD0886
10/01/2015 10/01/2016
ANY AUTO
SCHEDULED
ALL OWNED
AUTOS
X
$2,000,000
$
OTHER:
HIRED AUTOS
COMBINED SINGLE LIMIT
fEa accident)
$1,000,000
BODILY INJURY(Per person)
$
BODILY INJURY(Per accident) $
AUTOS
PROPERTY DAMAGE
(Per accident)
NON-OWNED
X
AUTOS
$
s
B
X
UMBRELLA LIAS
X
EXCESS LIAB
DEO
C
02RHURO5491
OCCUR
10/01/2015 10/01/201 e
CLAIMS-MADE
$25,000,000
$25,000,000
X RETENTION $10,000
$
WORKERS COMPENSATION
02WECR4310
'
V PER
10/01/2015 10/01/2016 A RTATIJTF
OTHER
Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVErm
QFFJCER/MEMBER EXCLUD
(Mandatory In NH]
If yes. describe under
E.L. EACH ACCIDENT
$1,000,000
N/A
E.L, DISEASE - EA EMPLOYEE 11:000:000
E.L DISEASE - POLICY LIMIT
DESCRIPTION OF OPERATIONS below
D
EACH OCCURRENCE
AGGREGATE
013478346
Professional E&O
05/31/2015 05/31/2016
$1,000,000
$15,000,000 Each Act
inc! Cyber &
$15,000,000 Aggregate
Privacy Llabllitv
"Claims Made"
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES(ACORD 101, Additional Remarks Schedule, may be attached If more space Is required]
CRifvIE
Insurer D - Policy #015934927 - Effective 08/01/2015 to 08/01/2016
Loss of Client Assets Limit: $5,000,000
30 days notice of cancellation, 10 days for non payment of premium afforded the certificate holder per form
IH 03 13 06 11.
CANCELLATION
CERTIFICATE HOLDER
Stephen F. Austin State University
Dora Fuseller, Controller
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
accordance with THE POLICY PROVISIONS.
SFA Station
AUTHORIZED REPRESENTATIVE
Box 13035
Nacogdoches, TX 75962-3035
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