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AGENCY CUSTOMER ID: <br />LOC #: <br />ACC)R & ADDITIONAL REMARKS SCHEDULE <br />Page 2 Of 2 <br />AGENCY <br />NAMED INSURED <br />Willis of Texas, Inc. <br />NEC Cotporaticn of Amoxicn <br />3929 W. Jobs Carpanter Praeway <br />Irving, TX 75063 <br />POLICY NUMBER <br />See Page 1 <br />CARRIER <br />NAIC CODE <br />See Page S <br />See Page I <br />EFFECTIVE DATE: Bee Page 1 <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: certificate of Liability Insurance <br />performed for the City of Santa Ana. This insurance applies separately to each insured against whom claim is made or <br />suit is brought except with respect to the company's limits of company's limits of liability. The inclusion of any <br />person or organization as an insured shall not affect any right which such person or organisation would have as a <br />claimant if not so included. <br />ACORD 101 (2008101) <br />t Gdy <br />psalsten <br />Q 2008 ACORD <br />The ACORD name and logo are registered marks of ACORD <br />SR ID: 15831977 sxTcs, 640766 caaT� W5539785 <br />reserved. <br />