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AGENCY CUS10M ER ID: INTCCN6 <br />LOCK: <br />Av d ADDRIDNALREMARKSSCHEDULE PapaL-m-L- <br />aaNtr <br />Van Gilder Insurance Corp WvmoiffiUUs <br />Interwest Consulting Group <br />1076 Lincoln Place <br />vulCruNYRER Boulder CO 80101 <br />49P1ER NWttWE <br /> BiFCmI WIL <br />ADDITIONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORMNUMBER: ES FORMTRLE: CERTIFICATE OF LIABILITY INSURANCE <br />Umbrella / Excess Liability but only with respect to liability arising out of the Named Insured's work <br />performed on behalf of the certificate holder and owner. This insurance will apply on a primary, <br />non-contributory basis. A Waiver of Subrogation applies for General Liability, Automobile Liability, <br />Umbrella/ExCess Liability and Workers' Compensation. Limited Contractual Liability is included. The <br />Umbrella / Excess Liability policy provides excess coverage over the General Liability, Automobile <br />Liability and Employers Liability. <br />dditional insured and Waiver of Subrogation: The City of Santa Ana, its officers, employees, agents, <br />volunteers and representatives <br />ACORO tO11EDOMDTI O300BACORD CORPORATION. All tlohb reurred. <br />the ACORO name and bM0 are rphhred maNo of ACORO