Laserfiche WebLink
AGENCY CUSTOMER ID: CN103042465 <br />ACD <br />11.� <br />LOC#: Cincinnati <br />ADDITIONAL REMARKS SCHEDULE <br />Page 2 of 2 <br />AGENCY <br />NAMED INSURED <br />Marsh USA Inc. <br />Statewide Traffic Safety & Signs, Inc. <br />dba Statewide Safety Systems <br />522 Unclad Lane <br />POLICY NUMBER <br />Nipomo, CA 93444 <br />CARRIER <br />NAIC CODE <br />EFFECTIVE DATE: <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 20 FORM TITLE: <br />Professional Uability <br />Limit $2,000,000 <br />Claims Made, Ran Date: 324/14 for first $1 M, 5129/15for 2nd $1 M <br />Contractors Pollution Liability <br />Each Pollution Condition: $1,000,000 <br />Aggregate: $2,000,000 <br />Claims Made, Retm Dale: 31242014 <br />ACORD 101 (2008101) © 2008 ACORD <br />The ACORD name and logo are registered marks of ACORD <br />,s'rl RiaktomagemmtDhislon <br />REVIEWED & APPROVED BY: <br />A+., Aav=- <br />- Risk Managemen[Specialist <br />