AQUA BACKFLOW, INC. - Laserfiche WebLink

EFFECTIVE DATE: NAMED INSURED POLICY NUMBER NAIC CODECARRIER AGENCY LOC #: AGENCY CUSTOMER ID: ofPageADDITIONAL REMARKS SCHEDULE ADDITIONAL REMARKS FORM TITLE:FORM NUMBER: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD 101 (2008/01) 1 1 Southwest Insurance Center Q73-0015450, Q61-0381561, VPPL020722 ERIE INS CO OF NY 16233, 26263, 18961 Aqua Backflow Inc. 25 Certificate Of Liability Insurance City of Pleasanton, its officers, employees and agents are an additional insured per the Business Liability Coverage Form SS0008, attached to this policy. Blanket Waiver of Subrogation applies in favor of the Certificate Holder per the Waiver of Our Right to Recover from Others Endorsement WC000313, attached to this policy. Notice of Cancellation will be provided in accordance with Form SS1223, attached to this policy. Coverage is primary and noncontributory per the Business Liability Coverage Form SS0008, attached to this policy. Waiver of Subrogation applies in favor of the Certificate Holder per Waiver of Subrogation Form SS1215, attached to this policy. Waiver of Subrogation applies in favor of the Certificate Holder per the Business Liability Coverage Form SS0008, attached to this policy. Certificate holder is an additional insured per the Business Liability Coverage Form SS0008 attached to this policy. Certificate holder is an additional insured per the Commercial Auto Broad Form Endorsement HA9916, attached to this policy. Notice of Cancellation will be provided in accordance with Form IH0313, attached to this policy. Coverage is primary and non-contributory per the Commercial Auto Broad Form Endorsement HA9916, attached to this policy. Waiver of Subrogation applies in favor of the Certificate Holder per the Commercial Auto Broad Form Endorsement HA9916, attached to this policy. Docusign Envelope ID: C28A2C39-714E-400A-AFC0-5A2400EC31E6