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ACOREY <br />lk,.� <br />AGENCY CUSTOMER ID: GOVEREV-01 <br />LOC #: <br />ADDITIONAL REMARKS SCHEDULE <br />CSOKOLOWSKI <br />Pace 1 of 1 <br />AGENCY <br />NAMED INSURED <br />Thompson Flanagan Executive Liability Group <br />Government Revenue Solutions Holdings LLC <br />dib/a MuniServices, LLC <br />Attn: Ms. Patricia Dunn <br />POLICYNUMBER <br />EE PAGE 1 <br />7625 N Palm Ave., Ste 108 <br />_ <br />Fresno, CA 88711 <br />CARRIER <br />NAIC CODE <br />EE PAGE 1 <br />s AA1T1l1 A, 111 CICIIP AVn <br />SEE P 1 <br />EFFECTIVE DATE: SEE PAGE I <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: ACORD 26 FORM TITLE: Certificate of Liability Insurance <br />California Workers Compensation <br />A separate policy number is applicable to California Workers' Compensation: 01-24.16. The same Insurer (American Casualty <br />Company of Reading, Pennsylvania) and effective date (01.24-18) are applicable. Policy number is WC643362553. Workers' <br />Compensation limits are per state <br />statute. Employer's Liability limits are as follows: Each Accident - $1,000,000; Disease Each Employee - $1,000,000; and Disease <br />Policy Limit • $1,000,000. <br />ACORD 101 (2008101) <br />© 2008 ACORD CORPORATION. All rinhts <br />I he ACURD name and logo are registered marks of ACORD <br />