Laserfiche WebLink
AGENCY CUSTOMER ID: HUITTZOL <br />AC RO O® <br />lh.� <br />S�PiiA <br />ADDITIONAL REMARKS SCHEDULE <br />Page 1 of 1 <br />AGENCY <br />MHBT, a Marsh & McLennan Agency, LLC company <br />NAMED INSURED <br />Huitt-Zollars, Inc. <br />1717 McKinney Ave., Ste. 1400 <br />Dallas TX 75202-1236 <br />POLICY NUMBER <br />CARRIER <br />NAIC CODE <br />EFFECTIVE DATE: <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE <br />- of subrogation form #WC00 edition 03/13 and #WC04 edition 03/06 and #WC420304B applies to the Workers Compensation policy <br />anal Insured form #XL0003 edition 09/16 applies to the Umbrella policy. <br />of Cancellation form #I1-10307 edition 6111 applies to the General Liability policy. <br />of Cancellation form #WC99 edition 03194 and #WC990531 applies to the Workers Compensation policy. <br />of Cancellation form #IH0307 edition 06/1 lapplies to the Umbrella Liability policy. <br />of Cancellation form #I1-10307 edition 06/11 applies to the Auto policy. <br />The General Liability policy contains language that provides additional insured status to the certificate holder only when there is a written contract between the <br />named insured and the certificate holder that requires such status. <br />The General Liability policy contains an endorsement with "Primary and NonContributory" wording that may apply only when there is a written contract between <br />the named insured and the certificate holder that requires such wording. <br />The General Liability policy contains a blanket waiver of subrogation endorsement that may apply only when there is a written contract between the named <br />insured and the certificate holder that requires such wording. <br />The Automobile Liability policy contains language that provides additional insured status to the certificate holder only when there is a written contract between <br />the named insured and the certificate holder that requires such status. <br />The Automobile liability policy includes waiver of subrogation wording that may apply only when there is a written contract between the named insured and the <br />certificate holder that requires such wording. <br />The Auto Liability policy contains an endorsement with "Primary and NonContributory" wording that may apply only when there is a written contract between the <br />named insured and the certificate holder that requires such wording. <br />The Worker's Compensation policy includes a waiver of subrogation endorsement that may apply only when there is a written contract between the named <br />insured and the certificate holder that requires such wording. <br />The Umbrella policy includes a blanket additional insured endorsement to the certificate holder only when there is a written contract between the named insured <br />and the certificate holder that requires such status. <br />The General LiabilityAuto, Worker's Compensation and Umbrella liability policies includes a blanket notice of cancellation to the certificate holder endorsement, <br />providing 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 <br />of premium. 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 <br />cancellation to the certificate holder if the named insured requests cancellation. <br />AI IJKU I Ul (ZUU6/Ulj © 2008 ACORD CI <br />The ACORD name and logo are registered marks of ACORD <br />Rick Moutganart Derision <br />.sqlREMEwso & APPROVED BY: <br />r' F z vj&,4d <br />®'t <br />® Ruk Management Mays[ <br />