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AGENCY CUSTOMER ID: CN102452723 <br />LOC #: Irvine <br />ACOl ADDITIONAL REMARKS SCHEDULE Page 2 of 2 <br />AGENCY <br />NAMED INSURED <br />Marsh Risk & Insurance Serviceso <br />Overland, Pacific & Cutler, LLCO <br />3750 Schaufolo Avenuou <br />Suite 1600 <br />POLICY NUMBER <br />Long Beach, CA 90808 <br />CARRIER <br />TAIC CODE <br />l EFFECTIVE DATE; <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance <br />Workers Compensation Carriers (by State): 0 <br />1) CA- Hartford Fire Insurance 0 <br />2) NV - Twin City Fire Insurance Company 6 <br />3) TX - Hartford Underwriters on <br />ACORD 101 (2008/01) @ 2008 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />E6Ci HEREDIA (PG FF -) <br />