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DocuSign Envelope ID:418ADAA3-2F7B-4243-AF32-4541 C164B6FA <br /> AGENCY CUSTOMER ID: <br /> LOC#: <br /> AR ADDITIONAL REMARKS SCHEDULE Page 2 of 2 <br /> PRODUCER INSURED <br /> MCGRIFF,SEIBELS&WILLIAMS,INC. DH Griffin Infrastructure LLC <br /> POLICY NUMBER <br /> CARRIER NAIC CODE <br /> ISSUE DATE: 01/13/2017 <br /> ADDITIONAL REMARKS <br /> THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br /> FORM NUMBER: FORM TITLE: <br /> Pollution Liability <br /> Carrier: Navigators Specialty Insurance Co <br /> Policy No. : CH15ECP828559IC <br /> Effective Date: 10/01/15 <br /> Expiration Date: 10/01/17 <br /> Each Occurrence: 10,000,000 <br /> Aggregate: 10,000,000 <br /> ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD CERTIFICATE NUMBER: HMWWFJ3Z <br />