RAISING CANE'S RESTAURANTS, LLC. (2)

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AGENCY CUSTOMER 10: _ LOC#: -4CC>R oP ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED See Page 1 see Page 1 POLICY NUMBER Sea Page 1 CARRIER NAIC CODE See Page 1 See Page 1 EFFECTIVE DATE:See Page 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Additional Named Insureds: Raising Cane's Restaurants, LLC Raising CaneTs USA, LLC Raising CaneTs Franchising, LLC Raising CaneTs Gift Cards, LLC 132 East State Street LLC Eat It LLC Lloyd Bartlett, Inc. Restaurant Recovery, LLC Sockeyes GL PPC Sockeyes LP The Epicurean LLC *Automobile* Physical Damage: - Comprehensive Deductible: $5,000 - Collision Deductible: $5,000 Hired Car Physical Damage: - Limit: $115,000 - Comprehensive Deductihle: $5,000 - Collision Deductible: $5,000 *Workers Compensation* - All States except Monopolistic - WA, WY, OR, ND Blanket Additional Insured form #CG 20 26 applies to the General Liability policy. Additional Insured - Vendors form #CG 20 15 applies to the General Liability_policy. Additional Insured - Managers or Lessors of Premises form #CG 20 11 applies to the General Liability policy. Additional Insured - Mortgagee, Assignee or Receiver form #CG 20 18 applies to the General Liability policy. Additional Insured - Lessor of Leased Equipment form #CG 20 28 applies to the General Liahility policy. Additional Insured State or Political Subdivisions - Permits Relating to Premises form 4CC3 20 13 applies to the General Liability policy, Waiver of subrogation form #CG 24 04 applies to the General Liability policy. Primary & Non-Contributory General Liability form #SNCA 023. Lessor - Additional Insured and Loss Payee form #CA 20 01 applies to the Business Auto policy. Designated Insured - Name of Person or Organization form #SNCA 026 applies to the Business Auto Policy. Primary & Non-Contributory Auto Liability form # CA 04 49 Waiver of Subrogation form #SNCA 027 applies to the Business Auto policy. Waiver of Subrogation form #WC 00 03 13 applies to the Workers Compensation policy. Texas Waiver of Subrogation form #WC 42 03 043 applies to the Workers Compensation policy. The General Liability policy includes a blanket additional insured endorsement to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status. The General Liability policy contains an endorsement with "Primary and Noncontributory" wording that may apply only when there is a written contract between the named insured and the certificate holder that requires such wording. The General Liability policy contains a blanket waiver of subrogation endorsement that may apply only when there is a written contract between the named insured and the certificate holder that requires such wording, The Automobile Liability policy contains language that provides additional insured status to the certificate holder only when there is written contract between the named insured and the certificate holder that requires such status. The Automobile Liability policy contains an endorsement with "Primary and Noncontributory" wording that may apply only when there is a written contract between the named insured and the certificate holder that requires such wording. The Automobile liability policy includes waiver of subrogation wording that may apply only when there is a written contract between the named insured and the certificate holder that requires such wording. The Werker`s Compensation policy includes a waiver of subrogation endorsement that may apply only when there is a written contract between the named insured and the certificate holder that requires such wording ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD