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ACORD 101 (2008/01) <br />The ACORD name and logo are registered marks of ACORD <br />© 2008 ACORD CORPORATION. All rights reserved. <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER:FORM TITLE: <br />ADDITIONAL REMARKS <br />ADDITIONAL REMARKS SCHEDULE Page of <br />AGENCY CUSTOMER ID: <br />LOC #: <br />AGENCY <br />CARRIER NAIC CODE <br />POLICY NUMBER <br />NAMED INSURED <br />EFFECTIVE DATE: <br />DISA Global Solutions, Inc. <br />Attn: Accounts Receivable <br />11740 Katy Freeway <br />Suite 900 <br />Houston, TX 77079 <br />Orange County, its officer, agents and employees are included as Additional Insureds as respects to General Liability, <br />Auto Liability and Umbrella/Excess Liability. <br />Waiver of Subrogation applies in favor of Additional Insureds with respects to Workers Compensation as permitted by <br />law. <br />INSURER AFFORDING COVERAGE: Vantage Risk Specialty Insurance Company NAIC#: 16275 <br />POLICY NUMBER: P03HC0000071450 EFF DATE: 11/08/2024 EXP DATE: 11/08/2025 <br />TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: <br />Professional Liability Ea. Claim & Aggregate $5,000,000 <br />Claim Made Retention $250,000 <br />ADDITIONAL REMARKS: <br />Ohio Stop Gap Employers Liability: $750,000/$750,000/$750,000 excess of $250,000 Self Insured Retention for a total <br />Limit of $1,000,000/$1,000,000/$1,000,000 <br />Abuse & Molestation Sublimit $1,000,000 <br />2 2 <br />Willis Towers Watson Northeast, Inc. <br />See Page 1 <br />See Page 1 See Page 1 See Page 1 <br />25 Certificate of Liability Insurance <br />W38697057CERT:3930239BATCH:27642171SR ID: <br />Docusign Envelope ID: A4CA1836-F4CC-417F-A6B3-95651F565E3A