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ACORE® <br />AGENCY CUSTOMER ID: INTEHOU-03 <br />LOG #: <br />ADDITIONAL REMARKS SCHEDULE <br />Paaa f of <br />AGENCY <br />NAMED INSURED <br />Arthur J. Gallagher & Co. <br />Interval House <br />P.D. Box 3356Seal Beach, CA 90740 <br />POLICY NUMBER <br />CARRIER <br />NAIL CODE <br />EFFECTIVEDATE: <br />AnnITIAKIAI MCI,.IAMWO <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY <br />jPolicy: <br />transfer fraud: Limit:$3,000,000 / Deduct <br />orders and counterfeit paper currency: L <br />' Property (Other): Limit:$3,000,000 / Del <br />Abuse or Molestation Liability <br />HHS8525626-13 <br />' Berkley National Insurance Company <br />Term: 10/1/2019 To 10/1/2020 <br />rim: $1,000,000 /Aggregate: $3,000,000 <br />al Insurance Company <br />,To 10/1/2020 <br />/Aggregate: $3,000,0( <br />/ Deductible : $25,000 <br />Berkley National Insurance Company <br />arm: 1011/2019 To 10/1/2020 <br />Building: Limit: $5,231,005 / Deductible $1,000 <br />Business Personal Property: Limit: $872,540 / Deductible $1,000 <br />& Officers Liability <br />Philadelphia Indemnity Insurance Company <br />erm: 10/1 /2019 To 10/1/2020 <br />m: $1,000,000 /Aggregate: $1,000,000 / Retention: $0 <br />of Santa Ana, its officers, employees, agents, volunteers and representatives are named additional insured with respect to the operations of the named <br />Norkers Compensation coverage is evidence only. <br />urance is Primary and Non -Contributory. Written notice shall be provided at least ten (10) days in advance of cancellation for non-payment of premium <br />(30) days in advance for any other cancellation or policy change. <br />101 (2008/01) <br />REVIEWED & APPROVED <br />By Risk MANAGEMENT DIVISION <br />© 2008 <br />riahts <br />I ne AL,urtu name and logo are registered marks of ACORD <br />