AGENCY CUSTOMER ID: PIERCGOO LOC #:

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AGENCYUSI Southwest NAMED INSUREDPierce Goodwin Alexander & Linville, Inc.PGAL, Inc.; PGAL, LLC3131 Briarpark Drive, Suite 200Houston TX 77042

POLICY NUMBER

CARRIER NAIC CODE

EFFECTIVE DATE:

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE

endorsement that provides Additional Insured status to the Certificate Holder only when there is a written contract that requires such status, and only regarding work performed on behalf of the named insured. Coverage provided on the General Liability is primary and non-contributory if required by written contract executed prior to a loss. All policies listed provide a Blanket Waiver of Subrogation as required by written contract executed prior to a loss, except as prohibited by law. All policies listed include an endorsement providing that 30 days notice of cancellation for reasons other than nonpayment of premium and 10 days notice of cancellation for non-payment of premium will be given to the Certificate Holder by the Insurance Carrier, if required by written contract. The Umbrella Liability policy follows form to the underlying General and Automobile Liability, and Workers Compensation policies. Insured does not own any autos.