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AGENCY CUSTOMER ID: <br />LOC #: <br />ACCA?" ADDITIONAL REMARKS SCHEDULE Page 2 Of 2 <br />AGENCY NAMED INSURED <br />Willis of Minnesota, Inc. HDR Engineering, Inc. <br />8404 Indian Hills Drive <br />POLICY NUMBER Omaha, NE 68114 <br />See Page 1 <br />CARRIER NAIC CODE <br />See Page 1 See Page 1 1 EFFECTIVE DATE: See Page - 1 <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance <br />LIABILITY. <br />REVIEWED BY: 6-1111M EUNICE HEREDIA (PG OF 1) <br />FA�'Umu IU-1 (ZUU01U-Ij (9) 2008 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />SR ID: 14647678 BATCH: 333625 CERT: W2352173 <br />