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AGENCY CUSTOMER ID: <br />LOC #: <br />A4CC)Ra ADDITIONAL REMARKS SCHEDULE <br />Page 2 of 2 <br />v <br />AGENCY <br />NAMEDINSURED <br />Elecnox eloo Electric, Inc. <br />Willie Towers Watson Northeast, Inc. <br />14320 Albers Way <br />Chino, CA 91710 <br />POLICY NUMBER <br />Be. Page 1 <br />CARRIER <br />NAIC CODE <br />EFFECTIVE DATE: See Page 1 <br />See Page 1 <br />See Page 1 <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance <br />General Liability and Auto Liability shall be Primary and Non-contributory with any other insurance in force for or <br />which may be purchased by Additional Insured. <br />waiver of Subrogation applies in favor of Additional Insured with respects to General Liability, Auto Liability and <br />workers Compensation, as permitted by law. <br />Excess policy(ies) is excess over the General Liability, Automobile and Employers Liability. <br />Additional Insureds: The Entity, its officers, officials, employees, and volunteers <br />INSURER AFFORDING COVERAGE: Navigators Insurance Company <br />POLICY NUMBER: NR23EEC91B9061V EFF DATE: 11/01/2023 <br />TYPE OF INSURANCE: LIMIT DESCRIPTION: <br />Excess Liability Each Occurrence <br />Aggregate <br />F.x DATE: 11/01/2024 <br />LIMIT AMOUNT: <br />$5,000,000 <br />$5,000,000 <br />ACORD 101 (2008/01) 0 zUUO AUUMU <br />The ACORD name and logo are registered marks of ACORD <br />SR ID: 26189463 PATCH: 3546161 CERT: W34321134 <br />NAIC#: 42307 <br />RA MmmgYm mtDWI0n <br />REVIEWED & APPROVED BY: <br />4�1 A4 44 <br />'®' <br />Risk Management Specialist <br />