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AGENCY CUSTOMER ID: 570000021966 <br />LOC #: <br />A ADDITIONAL REMARKS SCHEDULE <br />Page _ of <br />AGENCY <br />Aon Risk services southwest, Inc. <br />NAMEDINSURED <br />]wGUSA Holdings, Inc. <br />POLICY NUMBER <br />See Certificate Number: 570087917805 <br />CARRIER <br />See Certificate Number: 570087917805 <br />NAIC CODE <br />EFFECTIVE DATE: <br />ADDITIONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURER <br />INSURER <br />INSURER <br />INSURER <br />ADDITIONAL POLICIES If a policy below does not include limit information, refer to the coiTesponding policy on the ACORD <br />certificate form for policy limits. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INSD <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY <br />EFFECTIVE <br />DATE <br />(MM/DD/YYYY) <br />POLICY <br />EXPIRATION <br />DATE <br />(MM/DD/YYYY) <br />LIMITS <br />OTHER <br />A <br />Env contr Poll <br />CPL12456119 <br />claims Made- Poll. Liab. <br />SIR applies per policy to <br />07/01/2021 <br />ms & condit <br />07/01/2022 <br />ons <br />Aggregate <br />Limit <br />$5,000,000 <br />Per Loss <br />Limit <br />$5,000,000 <br />ACORD 101 (2008/01) <br />The ACORD name and logo are registered marks of ACORD <br />©2008ACORD HortaNe RAManagementDiMisian <br />REVIEWED & APPROVED BY. - <br />Risk Management Analyst <br />