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DocuSign Envelope ID:561AE95D-AC72-4264-B6FD-D416224A6CC5 <br /> AGENCY CUSTOMER ID: 100129 <br /> LOT;#: Morristown <br /> ADDITIONAL REMARKS SCHEDULE � Page 2 of 2 <br /> may. <br /> AGENCY NAMED INSURED <br /> MARSH USA,INC.. SIE MEN S INDU STRY,INC. <br /> — -_—_--- -- BUILDING TECHNOLOGIES <br /> POLICY NUMBER IODGDEERFIELD PARKWAY <br /> BUFFALO GROVE,IL 6M <br /> CARRIER - �-- --------- --�--- NA1C COUP <br /> EFFECTIVE DATE: <br /> ADDITIONAL REMARKS <br /> THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORTH, <br /> FORM NUMBER: 25 FORM TITLE: Cerlificate of Liability Insurance <br /> RE:JOB NO,WA <br /> I <br /> COUNTY OF ORANGE;ASSET MANAGEMENT SERVICES IS INCLUDED AS ADDITIONAL INSURED UNDER THE ABOVE REFERENCED GENERAL tMILITY AND <br /> AVTOMOBILE LIABILITY INSURANCE POLICIES AND THE COVERAGE AFFORDED THE ADDITIONAL INSURED UNDER THESE POLICIES SHALL BE PRIMARY AND NOW I <br /> CONTRIBUTORY INSURANCE TO THE EXTENT THAT A CLAIM ARISES FROM THE NEGLIGENCE OF SIEMENS INDUSTRY,INC.OR II$SUBCONTRAC1 ORS WITH <br /> RESPECT TO ALL OPERATIONS OF THE INSURED BUT ONLY WITH RESPECT TO ALL WORT(PERFORMED BY AND ON BEHALF OF THE NAMED INSURED,SIEMENS <br /> INDUSTRY,INC.FOR CERTIFICATE HOLDER UNDER CONTRACT. <br /> IF THESE PDLICIES ARE CANCELLED FOR ANY REASON OTHER THAN NON PAYMENT OF PREMIUM,THE INSURER WILL DELIVER NOTICE OF CANCELLATION TO <br /> THE CERTIFICATE HOLDER UP 10 60 DAYS PRIOR TO THE CANCELLATION OR AS REQUIRED BY WRITTEN CONTRACT,WHICHEVER IS LESS. <br /> I <br /> 1 <br /> 4 <br /> ACORD 101(2008101) Q 2008 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br /> I <br />