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AGENCY CUSTOMER ID:OCEABLU-06 ADAVIS2 <br /> LOC#: 1 <br /> ACORO ADDITIONAL REMARKS SCHEDULE Page 1 of 1 <br /> AGENCY License#0757776 NAMED INSURED <br /> HUB International Insurance Services Inc. Ocean Blue Environmental Services,Inc. <br /> 925 West Esther Street <br /> POLICY NUMBER Long Beach,CA 90813 <br /> SEE PAGE 1 <br /> CARRIER NAIC CODE <br /> SEE PAGE 1 SEE P 1 EFFECTIVE DATE:SEE PAGE 1 <br /> ADDITIONAL REMARKS <br /> THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br /> FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance <br /> Description of Operations/Locations/Vehicles: <br /> form CA9948 10/13. Waiver of Subrogation applies with regards to the Workers Compensation policy when required by a written <br /> contract, per the attached endorsement form WC040306 04/84. Excess Liability follows form to the General Liability,Auto Liability <br /> and Employers Liability. <br /> MCS-90 applies to the Auto Liability and Excess Liability per the forms to follow from the carrier. <br /> ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />