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2011-03-09 CC Packet
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2011-03-09 CC Packet
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3/4/2011 2:18:44 PM
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AGENCY GUST�MER ID: �RH2O229 <br /> LOC#: <br /> ' ° ADDITIONAL REMARKS SCHEDULE Page�of S_ <br /> 6ENCY NAMEDINSURED <br /> Willis of Illiaois, Inc. 7155eBrianeDriveB Club <br /> Pa.icrau�seR Centerville, l�T 55038 <br /> See First Page <br /> CARRIER NAIC CODE <br /> ACS Aansrican Insuraace CQID SA 22667-002 EFFECTNEDATE: $ge First Pa @ <br /> ADDITIONAL REMARKS <br /> THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br /> FORM NUMBER: 25 FORM T{TLE: �RTIFICATE OF LIABILITY INSIIRANCB <br /> aegligence of said Additional Insured. <br /> I <br /> ACORD107(2008I01) Co11:3286171 Tp1:1133739 Cert:15598196 �2008ACORDCORPORATION.Allrightsreserved. <br /> The ACORD name and lo�o are reqistered marks of AGORD <br /> �� <br />
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