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DocuSign Envelope ID:4FE28997-8839-4B4D-BA87-1A027F8E5CED <br /> AGENCY CUSTOMER ID: COUNOFD-01 <br /> _ LOG#: <br /> AC V ADDITIONAL REMARKS SCHEDULE Page 1 of 1 <br /> AGENCY NAMED INSURED <br /> Arthur J.Gallagher Risk Management Services,Inc. County of Durham <br /> Durham Co Courthouse <br /> POLICY NUMBER 3rd Floor#200 <br /> Durham NC 27701 <br /> CARRIER NAIC CODE <br /> EFFECTIVE DATE: <br /> ADDITIONAL REMARKS <br /> THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br /> FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE <br /> Governmental Immunity Endorsement. <br /> Property Deductible: Various Deductibles apply by coverage,but no lower than$25,000 in the occurrence to a maximum of$100,000 in the occurrence <br /> ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />