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CARRIER NAIC CODE <br />AGENCY <br />Crystal & Company <br /> <br />NAMED INSURED <br />Cascade Drilling. LP <br />17270 Woodinville Redmond Rd NE <br />Suite 777 Bldg A <br />Woodinville WA 98072 <br />POLICY NUMBER <br /> <br />EFFECTIVE DATE: <br />AGENCY CUSTOMER ID: CASCDR <br />LOC #: <br />ACORD ADDITIONAL REMARKS SCHEDULE Page 1 of 1 <br />ADDITIONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE <br />WORKERS' COMPENSATION: Waiver of Subrogation when required by written contract (WC000313) <br />All of the above is in accordance with the policy provisions and endorsements reflected. <br />Evidence of Insurance <br />ACORD 101 (2008/01) 0 2008 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD