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AGENCY CUSTOMER ID: <br />LOC 6: <br />1 vKLI ADDITIONAL REMARKS SCHEDULE Page a of 2 <br />AGENCY <br />NAMEh INSURED <br />Willis Towers Watson Insurance Services West, Inc, <br />Arakellan 5ntecptia0a Inc dbp Athens 4arViae6 <br />14040 Valley Sled, <br />POLICY HUMMER <br />City Of Induetry, CA 41746 USA <br />See Page 1 <br />CARRIeR <br />NAIC CODE <br />Sea Page i <br />T^� <br />See Page i <br />EFFECTNe DATE: See Page 1 <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: certificate of Liabilit <br />General Liability where required by written contract. <br />General Liability policy shall be Primary and Non-contributory with any other insurance in force for or which may be <br />purchased by Additional Insured where required by written contract. <br />iY A (" L7W <br />u'.f NIFNI J3iVr510N <br />MN <br />17Tlim <br />The ACORD name and logo are registered marks of ACORD <br />SR ID: 19340035 BATCH: 1601253 rERT: W15662281 <br />