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AGENCY CUSTOMER ID: INTERCON35 <br />LOC #: <br />ADDITIONAL REMARKS SCHEDULE <br />Page 1 of 1 <br />AGENCY <br />USI Colorado, LLC Prof Liab <br />NAMEDINSURED <br />Interwest Consulting Group <br />P.O. Box 18330 <br />Boulder CO 80308 <br />P <br />POLICY NUMBER <br />CARRIER <br />NAIC CODE <br />EFFECTIVE DATE: <br />nrw <br />FTHIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE <br />provides excess coverage over the General Liability, Automobile Liability and Employers Liability. <br />Please note that Additional Insured status does not apply to Professional Liability or Workers' Compensation <br />Additional Insured: City of Santa Ana, its officers, agents and employees <br />Policies include 30 Day Notice of Cancellation in favor of City of Santa Ana. <br />© 2008 ACORD CORPORATION. All <br />The ACORD name and logo are registered marks of ACORD <br />