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5 V <br /> AGENCY CUSTOMER ID: GEMSENVI <br /> LOC#: <br /> ACCW ADDITIONAL REMARKS SCHEDULE Page 1 of 1 <br /> AGENCY NAMED ENSURED <br /> Edgewood Partners Insurance Center GEMS Environmental Management Services,Inc. <br /> 1120 Willow Pass Court <br /> POLICY NUMBER Concord CA 94520 <br /> CARRIER NAIL CODE <br /> EFFECTIVE DATE: <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 /> When required by written contract,additional insured status with primary coverage applies to General Liability and Auto Liability. <br /> Waiver of subrogation applies to General Liability,Auto Liability and Workers'Compensation,all per the attached endorsements. <br /> 30 Days Written Notice of Cancellation for Non-Renewal <br /> Excess Liability follow forms of underlying CGL,Auto, Employers,Professional,and Pollution Liability policies. <br /> i <br /> ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />