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AGENCY CUSTOMER ID: <br />_ LOC #: <br />AADDITIONAL REMARKS SCHEDULE Page 2 of 2 <br />AGENCY NAMED INSURED <br />Willis of Pennsylvania, Inc. Crown Castle International <br />See Attached Named Insured List <br />POLICY NUMBER <br />1220 Augusta Dr. Suite 600 <br />See Page 1 Houston, Tx 77057 <br />CARRIER NAIC CODE <br />See Page 1 See Page 1 EFFECTIVE DATE: See Page 1 <br />ADDITIONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance <br />City of Santa Ana, its officers, agents, employees and volunteers are included as Additional Insureds under the <br />General, Automobile, and Excess Liability policies as required by written agreement and only with respect to the <br />liability arising out of the operations performed by or on behalf of the Named Insured. <br />General, Automobile, Excess Liability, and Workers Compensation policies include a Waiver of Subrogation in favor of <br />the Additional Insureds when required by written contract and as permitted by law but always subject to the policy <br />terms, conditions and exclusions. <br />General Liability and Umbrella/Excess Liability policies shall be Primary and Non-contributory with any other <br />insurance in force for or which may be purchased by Additional Insureds, as required by written contract. <br />Auto Liability policy shall be Primary and Non-contributory with any other insurance in force for or which may be <br />purchased by Additional Insureds. <br />ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights resereed_ <br />The ACORD name and logo are registered marks of ACORD <br />SR ID: 18296908 BATCH: 1295385 CERT: W12097965 <br />