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AGENCY CUSTOMER ID: HUITTZOL LOC #: A,COK® ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED MHBT, a Marsh & McLennan Agency, LLC company Huitt-Zollars, Inc. 1717 McKinney Ave., Ste. 1400 POLICY NUMBER Dallas TX 75202-1236 CARRIER NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Waiver of subrogation form #WC000313 edition 04/64 and #WC04 edition 03106 and #WC420304B applies to the Workers Compensation policy Additional Insured form #XL0003 edition 09116 applies to the Umbrella policy. Notice of Cancellation form #I1-10307 edition 6111 applies to the General Liability policy. Notice of Cancellation form #WC99 edition 03/94 and #WC990531 applies to the Workers Compensation policy. Notice of Cancellation form #IH0307 edition 6/11 applies to the Umbrella Liability policy. Notice of Cancellation form #I1-10307 edition 06/11 applies to the Auto policy. The General Liability policy contains language that provides additional insured status to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status. The General Liability policy contains an endorsement with "Primary and NonContributory" wording that may apply only when there is a written contract between the named insured and the certificate holder that requires such wording. a blanket waiver of subrogation endorsement that may apply only when there is a written contract between the named requires such wording. Automobile Liability policy contains language that provides additional insured status to the certificate holder only when there is a written contract between named insured and the certificate holder that requires such status. Automobile liability policy includes waiver of subrogation wording that may apply only when there is a written contract between the named insured and the ificale holder that requires such wording. Auto Liability policy contains an endorsement with "Primary and NonContributory" wording that may apply only when there is a written contract between the led insured and the certificate holder that requires such wording. Worker's Compensation policy includes a waiver of subrogation endorsement that may apply only when there is a written contract between the named red and the certificate holder that requires such wording. Umbrella policy includes a blanket additional insured endorsement to the certificate holder only when there is a written contract between the named insured the certificate holder that requires such status. General Liability, Auto, Worker's Compensation and Umbrella liability policies includes a blanket notice of cancellation to the certificate holder endorsement, ,iding for (30) days' advance written notice if the policy is canceled by the company, or 10 days' written notice before the policy is canceled for nonpayment ,emium. Notice is sent to certificate holders with mailing addresses on file with the agent or the company. The endorsement does not provide for notice of :ellation to the certificate holder if the named insured requests cancellation. 1n1 r200R/011 n 200R ACORD CORPORATION. All rights reserver) The ACORD name and logo are registered marks of ACORD