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1 <br />ACORO` <br />111,1� <br />AGENCY CUSTOMER ID: ARDURRA-01 <br />LOC #: 2 <br />ADDITIONAL REMARKS SCHEDULE <br />TBENSON <br />Page 1 of 1 <br />AGENCY <br />NAMED INSURED <br />Ardurra Group, Inc. <br />Ames & Gough <br />9 <br />4921 Memorial Highway <br />Suite 300 <br />POLICYNUMBER <br />Tampa, FL 33634 <br />EEPAGE1 <br />CARRIER <br />NAIC CODE <br />EFFECTIVE DATE: SEE PAGE 1 <br />EE PAGE 1 <br />SEE P 1 <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: ACORD 25 FORM TITLE: Ceitificate of Liability Insurance <br />Description of OperationslLocationsNehicles: <br />Liability, Workers Compensation, and Umbrella Liability policies include a waiver of subrogation in favor of the additional insureds <br />where permissible by state law and when required by written contract. 30-day Notice of Cancellation will be issued for the General <br />Liability, Automobile Liability, Umbrella Liability, Workers Compensation and Professional Liability policies in accordance with <br />policy terms and conditions. <br />ACORD 101 (2008/01) © 2008 ACORD CC <br />��.,�20 <br />e`9 <br />®' <br />ltirkMaissgnnndDlvieicn <br />REVIEWED&APPRa/®BY: <br />Risk Management Spetlkist <br />op <br />The ACORD name and logo are registered marks of ACORD <br />