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AGENCY CUSTOMER ID: 100406 <br />LOC#: <br />ADDITIONAL REMARKS SCHEDULE Paae-2 of 2 <br />AGENCY <br />NAMED INSURED <br />Willis Insurance Services of Georgia, Inc. <br />Commonwealth Land Title Company <br />Attn: Risk Mgmt Dept <br />601 Riverside Ave, Bldg 5 <br />Jacksonville, FL 32204 <br />POLICY NUMBER <br />See First Page <br />CARRIER <br />NAIC CODE <br />See First Page <br />EFFECTIVE DATE: See First Page <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE <br />Property $200,000,000 Limit Quota Share <br />Carrier & Policy Number Participation Percentage <br />Allianz #CLP3016282 15% of200M <br />Liberty Mutual Fire #MJ2L9L448030025 10% of HOOM <br />Zurich American #PPR489174106 17.5% of $200M <br />Ace American Ins #CXD37839000005 25% of $200M <br />Westport #NAP045198904 25% of $200M <br />AIG Europe #B080117339U15 7.5% of $200M <br />Special including Wind/Earthquake/Flood <br />Valuation - Property Damage Replacement Cost <br />The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers employees, <br />agents, volunteers and representatives are named as additional insureds ("additional insureds") <br />with regard to liability and defense of suits arising from the operations and uses performed by or <br />on behalf of the named insured. <br />The General Liability coverage is written on a Primary and Non -Contributory basis with the <br />Separation of Insureds form. <br />REVIEWED BY: <br />E:I,.JP�l(',El-9EREI.)IAOIG'74C)FS ) <br />At,UKU -I Ul (dUUt$/U1) Uo11:48U529U Tp1:2009169 Cert:23841307 @ 2008 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />