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AC RO O® <br />iii <br />AGENCY CUSTOMER ID: CN103150778 <br />LOG #: St. Louis <br />ADDITIONAL REMARKS SCHEDULE <br />Page 2 of 2 <br />AGENCY <br />NAMEDINSURED <br />Marsh USA Inc. <br />New Cingular Wireless PCS, LLC <br />One AT&T Plaza <br />208 South Akard <br />POLICY NUMBER <br />Room 1820 <br />Dallas, TX 75202 <br />CARRIER <br />NAIC CODE <br />EFFECTIVE GATE: <br />ADDITIONAL <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance _ <br />Excess Workers Compensation-MWXS 31363920(OHMA) <br />Sell Insured Retentions <br />OH & WA - $500.000,000 (except Tenonsm) <br />OH & WA - $600,000,000 Terrorism <br />Excess Automobile Liability- MWZX 31363720 (MI) <br />Combined Single Limit -$1,000,000 <br />Sett insured Retention - $1,00g000 <br />RENEMMis MPROVe r. <br />ACORD 101 (2008/01) © 2008 ACORD C <br />The ACORD name and logo are registered marks of ACORD pw aA;rwrOemerR arwTlpt <br />