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AGENCY CUSTOMER ID: <br /> _ LOC th <br /> ADDITIONAL REMARKS SCHEDULE Page 2 Of 2 <br /> AGENCY NAMED INSURED <br /> Kimble and Company <br /> Willis Towers Watson Midwest, Ina. 15182 solsa Chica Street, Suite A <br /> POLECYNUM6ER Huntington Beach, CA 92649 <br /> See Page 1 <br /> CARRIER NAIC CODE <br /> See Page 1 See Page J. EFFECTIVE DATE: gee Page i <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 /> waiver of Subrogation applies in favor of City, its City Council, its officers, officials, employees, agents, and <br /> volunteers with respects to General Liability, Auto Liability and workers Compensation when required by written <br /> contract and as permitted by law. <br /> ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br /> SR ID: 28162944 BATCH: 4063280 CERT: W39896455 <br />