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Last modified
4/23/2021 3:48:25 PM
Creation date
5/26/2020 9:47:01 AM
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Contracts
Company Name
T-MOBILE WEST CORPORATION
Contract #
A-2010-134-01
Agency
PARKS, RECREATION, & COMMUNITY SERVICES
Council Approval Date
7/19/2010
Expiration Date
10/31/2025
Insurance Exp Date
4/1/2021
Destruction Year
2030
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AGENCY CUSTOMER ID: <br />LOC #: <br />ACo ADDITIONAL REMARKS SCHEDULE <br />Page 2 of 2 <br />AGENCY <br />NAMED INSURED <br />Willis Towers Watson Northeast, Inc. <br />Croen Castle International <br />See Attached Named Insured List <br />1220 Augusta Dr. Suite 600 <br />POLICY NUMBER <br />Sea Page 1 <br />Houston, Tx 77057 <br />CARRIER <br />NAIC CODE <br />Sea Page 1 <br />Be- Page 1 <br />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 />as required by written agreement and only with respect to the liability arising out of the operations performed by or <br />on behalf of the Named Insured. <br />v/ <br />It is further agreed that such insurance as is afforded shall be Primary and Non -Contributory with any other insurance <br />in force for or which may be purchased by Additional Insureds if agreed in written contract. <br />General Liability, Auto Liability, Umbrella Liability and Workers Compensation policies include a Waiver of <br />Subrogation in favor of the Additional Insured when agreed in written contract prior to the loss, but always subject <br />to the policy terms, conditions and exclusions as permitted by law. <br />REVIEWED & APPROVED <br />By Risk MANAGEMENT DIVISION <br />JU 12020 <br />ANGIE ACEVEdo <br />© 2008 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />SR ID: 19759257 BATCH: 1719745 CERT: W16885429 <br />
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