Laserfiche WebLink
AGENCY CUSTOMER ID: <br />LOC #: <br />AC")?" ADDITIONAL REMARKS SCHEDULE Page 2 of 2 <br />AGENCY NAMEDINSURED <br />Scott & McCauley Insurance Agency LLC EBS GENERAL ENGINEERING, INC <br />POLICY NUMBER <br />1345 Quarry St <br />7018007493 <br />Suite 101 <br />CARRIER NAIC CODE Corona, CA, 92879 <br />NATIONAL FIRE INSURANCE COMPANY OF HARTFORD 20478 EFFECTIVE DATE: 02/01/2023 <br />ADDITIONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE <br />COVERAGE PROVIDED PER THE FOLLOWING COVERAGE FORMS: <br />GL - CNA75079XX (10-16)- Blanket Additional Insured -Owners, Lessees or Contractors -with Products -Completed Operations Coverage Endorsement <br />GL-CNA74705XX (1-15)-Additional Insured -Primary And Non-ContributoryTo Additional Insured's insurance <br />GL - CNA74705XX (1-15)- General Aggregate Limits of Insurance- Per Project <br />GL - CNA74705XX (1-15)- Waiver of Subrogation -Blanket <br />Auto-CNA63359XX (04-12) -Blanket Additional Insured when required by written contract <br />Auto - CNA63359XX (04-12) -Additional Insured -Primary And Non -Contributory To Additional Insured's Insurance <br />Auto - CNA63359XX (04-12) -Blanket Waiver Of Subrogation when required by written contract <br />WC - G-19160-B -WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT- CALIFORNIA <br />"UMBRELLA IS FOLLOW -FORM' <br />ACORD 101 (20081 1) © 2008 ACORD CORPORATION. All rights reserved. <br />r,e „s vmu narne ana Togo are registered marks of ACORD <br />