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AC` REP <br />i%..., ' <br />AGENCY CUSTOMER ID: 100129 <br />LOC #: Morristown <br />ADDITIONAL REMARKS SCHEDULE <br />Page 2 of 2 <br />AGENCY <br />MARSH USA, INC, <br />NAMED INSURED <br />SIEMENS INDUSTRY, INC, <br />1000 DEERFIELD PARKWAY <br />BUFFALO GROVE, IL 60069-4513 <br />POLICY NUMBER <br />CARRIER <br />NAIC CODE <br />EFFECTIVE DATE: <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER; 25 FORM TITLE: _Certificate of Liability Insurance <br />RE; 17-075 <br />CITY OF SANTA ANA, TYRONE CHESANEK IS HEREBY ADDITIONAL INSURED AS OBLIGATED UNDER CONTRACT UNDER THE REFERENCED GENERAL LIABILITY AND <br />AUTOMOBILE LIABILITY INSURANCE POLICIES. <br />SUCH INSURANCE AS IS AFFORDED BY THE ADDITIONAL INSURED ENDORSEMENT SHALL APPLY AS PRIMARY INSURANCE & OTHER INSURANCE MAINTAINED BY <br />THE CERTIFICATE HOLDER SHALL BE EXCESS ONLY & NOT CONTRIBUTING WITH INSURANCE PROVIDED UNDER THIS POLICY, <br />$1,000,000 PROFESSIONAL LIABILITY IS INCLUDED UNDER THE GENERAL LIABILITY POLICY AND $1,000,000 IS INCLUDED UNDER THE UMBRELLA LIABILITY POLICY. <br />IF THESE POLICIES ARE CANCELLED FOR ANY REASON OTHER THAN NON-PAYMENT OF PREMIUM, THE INSURER WILL DELIVER NOTICE OF CANCELLATION TO <br />THE CERTIFICATE HOLDER UP TO 60 DAYS PRIOR TO THE CANCELLATION OR AS REQUIRED BY WRITTEN CONTRACT. WHICHEVER IS LESS. <br />REVIEWED BY:4yllffEUNICE HEREDIA (PG OF ) <br />ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />