Laserfiche WebLink
AGENCY CUSTOMER 10: CONSAND-01 <br />LOC #: 1 <br />PARASHULADWA <br />AFRO <br />ADDITIONAL REMARKS SCHEDULE <br />Page 1 of 1 <br />AGENCY <br />License # CA#0658748 <br />NAMED INSURED <br />HT Insurance <br />Constant and Associates, Inc. <br />3655 Torrance Blvd., Suite 430 <br />Torrance, CA 90503 <br />POLICY NUMBER <br />EE PAGE 1 <br />CARRIER <br />NAIL CODE <br />EE PAGE 1 <br />SEE P 1 <br />EFFECTIVE DATE: SEE PAGE 1 <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance <br />Description of Operations/Locations/Vehicles: <br />Waiver of Subrogation applies to the Workers' Compensation in favor of the Additional Insured as per written contract and subject to <br />the provisions of the policy. Forms to follow. <br />ACORD 101 (2008/01) © 2008 ACORD COF <br />The ACORD name and logo are registered marks of ACORD <br />r. <br />Rtele 111arrugemmt Dtvislon <br />REVIEWED&APPROVEDBY: <br />®'. <br />® <br />Rlsk Managernen[Analyst <br />