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AGENCY CUSTOMER ID: <br /> LOG#: <br /> Ac" " ADDITIONAL REMARKS SCHEDULE Page 2 of z <br /> AGENCY NAMED INSURED <br /> ully-miller Contracting Company <br /> Willis Towers Watson Northeast, Inc. S <br /> 135 S. State College Blvd., Suite 400 <br /> POLICY NUMBER Brea, CA 92621 <br /> See Page 1 <br /> CARRIER NAIC CODE <br /> See Page 1 See Page 1 EFFECTIVE DATE:See Page 1 <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 /> The City of Santa Ana, its City Council, officers, officials, employees, agents and volunteers are included as <br /> Additional Insureds as respects to Umbrella/Excess Liability. <br /> Umbrella/Excess Liability policy shall be Primary and Non-Contributory with any other insurance in force for or which <br /> may be purchased by Additional Insureds. <br /> Waiver of Subrogation applies in favor of Additional Insureds with respects to Umbrella/Excess Liability. <br /> ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of'ACORD <br /> SR ID: 27418627 BATCH: 3870056 CERT. W30104652 <br />