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AGENCY CUSTOMER 1D: <br />LOG <br />ADDITIONAL REMARKS SCHEDULE lugs 2 of <br />ACIEMC V NAMUD INSURIED <br />Willis Tower8 Watson Nortboast; xnca Croun Castle Inc. <br />-T� See Atta'W-Wd NdMed ihoured Liat <br />POLICY NUMUR S020 ftty Irreaway <br />S" paime 1 ft"at.on, TX 77'02 F <br />CARRIER <br />Sae Pages 1 <br />MAID CODE - <br />See Page l ±VFEGTVCOATt See V,5. I <br />ADDITIONAL REMARK <br />THIS ADDITIONAL REMARKS PORM IS A SCH lWC7ULE TO ACOAD FOAM, <br />_FORM NUMBER, _., �6 FORM TITLE: CertiEiaate off' liability Xrws"ranae <br />Genexal,TLiability as�t heir interest may appearand as regtzi.red by written agreement and µonly with respeot to the <br />liability arisi g a it of the operations potformed by or on behalf of the Named Insured. <br />City of Santa Ana, its agents, omploymas and vol.uni e"re are 1-noluded as Additio4al '7Xnvurad4g as x:espoct s to <br />3#uta Liability Cy 40 their txt real rmy appear and as required by written agreement and only with respect to the <br />liability arising out; of they operations parf-ormod by or on behalf of the Named lnaured: <br />C ty ok Santa Aria, its rattiCers, agents, exnploymas and voluntoerh are inUwddwd as Additioraal Insurads as speats to <br />Wbrell.a/Excess Li abilLty their interest may appoar and as regr ixekd. by written agreement: and only with respfwot to <br />the liability a#rieing out: of tho operations performed by or on bo'ha.l:f of the Named Insured. <br />It is further agreed that such Inauxanue as is afforded shall be ;primary and Non-Contributor.y.wi+th any other insur^alloe <br />in force for or wrhiols may be puroba.sed by Addltidnal :lilsuveds if agreed in written nantxsdt <br />a4:nexal Liability, Auto ti:abil:ity, tlmbr:ello/Nxoes,s Liability and workers Co"naatlon include a wai..vvx of subrogation <br />is favor of the Additional. Insurads when agreed in written contract prier to the lass, but always subject to the <br />Volloy terms, conditions and exolusiona as permitted by lawn. <br />i <br />ACORD 101 (2008I01) 4 2008 ACORD CORPORATION. All Y.ighis reserved. <br />The ACORD name and logoare registered marks of ACC1,HD <br />SK sp: 29626546 l3x►TM 43776:1a CHRT: W45074401 <br />21041: 2 of6 I <br />