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FORM NUMBER: <br />EFFECTIVE DATE: <br />The ACORD name and logo are registered marks of ACORD <br />ADDITIONAL REMARKS <br />ADDITIONAL REMARKS SCHEDULE <br />FORM TITLE: <br />Page of <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />ACORD 101 (2008/01) <br />AGENCY CUSTOMER ID: <br />LOC #: <br />AGENCY NAMED INSURED <br />POLICY NUMBER <br />CARRIER NAIC CODE <br />© 2008 ACORD CORPORATION. All rights reserved. <br />Hub International Mid-America <br />TMAHOLD-01 <br />SEE PAGE 1 <br />1 <br />SEE PAGE 1 <br />ACORD 25 Certificate of Liability Insurance <br />License # 100101891 <br />1 <br />SEE P 1 <br />TMA Holdings LLC <br />1876 Utica Square <br />Third Floor <br />Tulsa, OK 74114 <br />SEE PAGE 1 <br />CRAMEY <br />1 <br />Retroactive Date 12-22-23 applies to VG00004285AD <br />DocuSign Envelope ID: A272695C-7FC7-4CE0-BF3E-30237E86D784