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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 />HOFF&HO-01 <br />1 1 <br />MP Specialty Insurance Hoffman &Hoffman Inc. <br />See Attached ACORD for Additional Named Insureds <br />3816 Patterson Street <br />Greensboro NC 27407 <br />25 CERTIFICATE OF LIABILITY INSURANCE <br />Where Required Under Contract or Agreement -87950 (09/14);Blanket -Insurance Primary as to Certain Additional Insureds -74445 (10/99);Blanket Waiver of <br />Transfer of Rights of Recovery Against Others to Us -Business Auto Coverage Form -62897 (06/95);Blanket Limited Advice of Business Auto Cancellation <br />Provided via E-Mail To Entities Other Than The First Name Insured -107414 (03/11);Blanket Workers Compensation Waiver of Our Right To Recover From <br />Others Endorsement -WC000313 (04/84);Blanket Limited Advice Cancellation Provided via E-Mail To Entities Other Than The Named Insured (Workers <br />Compensation Only)WC990056 (04/11);Excess Follow-Form and Umbrella Liability Additional Insured -EU0001 (07/16)Pg 4 of 23;Coverage is Primary & <br />Non-Contributory -EU0001 (07/16)Pg 15 of 23;Waiver or Transfer of Subrogation -EU0001 (07/16)Pg 16 of 23;Aggregated Limit Applies on a Per Project <br />Basis -EU0113 (07/16);Blanket Designated Entity -(30)Day Notice of Cancellation Provided by Us -ILT405 (05/19). <br />Docusign Envelope ID: 09D4125A-9C2E-46BB-8FA5-45DFCD0A5A01