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AGENCY CUSTOMER ID: <br />_ LOC #: <br />AR° ADDITIONAL REMARKS SCHEDULE Page 2 of 2 <br />AGENCY NAMED INSURED <br />Willie of Texas, Inc. NBC Corporation of Amerioa <br />3929 W. Cohn Carpenter Freeway <br />POLICY NUMBER Truing, TX 75063 <br />See Page I <br />CARRIER _ NAIC CODE <br />See Page i See Page 1 EFFECTIVE DATE: See Sage l <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 organization would have as a <br />claimant if not so included. <br />ACORD 101 (2008101) <br />The ACORD name and logo are regpistered marks of ACORD <br />SR ID: 16383493 snxes� 7T0054 cHRT, W6770062 <br />All riahts reserved. <br />