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AGENCY CUSTOMER ID: 011077 <br />LOC X: Milwaukee <br />ADDITIONAL REMARKS SCHEDULE Page 2 of 2 <br />M4 USA hr ,ahomn Cass N,lRc <br />PMSHWnNmdC�fm <br />iWCYNOXBER NN'.Cu14.MSkNgmrMai <br />PDao«4sl <br />Niwa,we,wl 0 <br />THIS AOOITIONAL REMARKS FORM IS A SCHEDULE i0 ACORO FORM, <br />FORM NUMBER: 25 FOAM TITLE: Cedgirate of Liability lNeafallCe <br />NORNENSCCMGENSVIIgV�NEWYCHN6IAlE <br />WOW mnOmsAOOmce*Ise sl�dUuotlailkNeaYOiXSIaIaWOMarsPnprasfimlauMatlE�ryhymsaod0 {eialhrsnNarYOiXSfa�. <br />4PIM4PYCG'JENAGE <br />theCew9f edlIYmVpuNrtudHCidGNpHkesareplrtaryaNmlasr�aoloimrd�fiogwX�oNaihsumxoiuNhsuace .rheam�uh¢db(p¢saoiomVaA <br />WPhEROf 6LIhNCCAiION <br />ih9ga' sINfNNIRgPUmrtoACaNfiy, M56CorvwpIIa11 Doffs WNINwwGtIpIYd9aNalRlfi6YsrNdINO NIamiHl�aC( AIfif2'kPoNBIAHBadPoI�NI¢OVYWSbd1. <br />wgmoNUlNSUaro- aurg�phh[ruwrHr <br />IDBBIrtoINMBNdhpONICgIIIB�NIP��N�Yd11, If�dSBIIXPEVIGO�B�lptll @�6SIE�OV01b�IXAVaCI <br />aoomoaulNSU�g- sEHEAU�IUn <br />klGawdNLaNOIY, II, ro�walbf mHlal, NBHkuiogHBf CIpdB18631VNW�If6Yl& 6, 6RjNI�rv�NIl0a0IDIlY1WnharvrtEdASI� ,�IWICyF,7C01�ABSNA28td{ i0. @plm�I91M"]H <br />Ik@ FalaYgNut161ENONiNEfIN6fPPGEOfiNISCffl11NC41EQflfPBIOIYM SOaPNCE, aWmo�oNtirvrs000ioigaoXtfimie�uii¢ db4a' rvldBlasmeNiO 'm9lom�pursuaolgar�limluiN <br />�BnaAAINGlle4. <br />6ChEgl @fCRPoIICYENWahEMENI6P7PINP21 <br />NamdPO111�N1rem ¢dFaem[oig9mhaMs'. <br />Xi¢ puiedVysoohal, ttapdunttgpe'¢ dAnlib. EooNamtlfirdeullomiao® �adOB' uoalios�, aod��olhaipe smuorymDetlmiaQul�bl§ IotlN��ao2All 'nrallosV�p��¢�IMamsfr�l <br />MNBOm�S601�. <br />laaVns A G.w¢1a1 p✓eenos <br />AsreAi�hyr�hffi <br />POUCVfNhOaSEMENiP1 <br />PfA010N4lMSOPEg�bIMIENS, lES6EES0RCIXVIRRCIONS�N0.MEdINS�PEL '6PCISOaOhVSSNNSgVIY <br />A$kwb YV�o 6BoroSUr�l6artanSdgIIaWBeas1941' �LNIS9WB1Mpg 6p1 6] 01019���b91tlafiAA9N��I�B, MOS�W��ISQB. Yhdtll� 'p�V[�Ih0Sly',�NHmd�IB�6�01 jB@tpa <br />dSd3♦tWVShg AIYI�t61fiA10k�N'. <br />YON�StlOrtiSSIN6',N <br />7.1Ha16IXOR66HbH�0"Rtt�Sh W�NID�4', <br />mulacer�rar lcemPua��reroaa' u�9wrcaa4a' omlHs��ls )almrrmaoml:lowartwamva <br />6. wr�lESps dpMBASUIareeflo�mlw99B�dI��9Ih6N�6 ,NBG�m�I�A1N91LNSh�68m1( <br />IHitlsuiar lceVOSOayplymrodryHjuryoigm�emda�a 'ousmYgaHr. <br />LWw�, lniuhimms@ raN �aM1Sn�u {maOfmHstlMHuno�1'nowlhsuhrWN, Doge% oj�oNaiNao�ni e,maoHoaoceui9pdrs]NlarvMrted VyoioodH9lAEaelddpmlhsm¢AsoIVa <br />I¢aV:n of Ira wrertd o{eiatlms 4as N¢I cardal�', of <br />2. I�alpaliand} omrurvN' bllolwXaN�anuryudm�¢ adsa�& �Wlt nRslrAN�u[ ablaoypesmaopm' ua�' mol�ttbe�e�oaewohaaims�lixMaowpsVmr eMmVm�¢EO,7skia <br />pdrrgal�aO�AetBempm�l <br />PoHCYENWaSEMENrAU <br />PWIIIONPIINSOPEOUIMENh, lES6EE6CRCgV[ PAGi0aSC�MPUiEhaPEPPiIONS�N4M EDINSONEhSPG60a01X6610NSONlY <br />as�nu�Wwlsho losualisamoAdlokNdaa; ao�RwallosarolX¢ pe rsmaiomgaolrAuosS7nnIoM. W�efuk, 4ulomywX4rey�mMVVryM• �Vyloimp 'm•pm{emoana�a•rauselstleM <br />4�' �WIYpk04BVSdh�dSBS�dd4Cp�B19�B SdItM119tlHb Hd6RmESy9H�N�iB19�C n911�1Rd8f41SdI�SHB�WiSWRQL�wB2tlSfi ��dA. <br />©70W ACORD CORPORATION. Allrghra reserved. <br />the ACORD name and lagoare mgplemtl malls of ACORD <br />