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AGENCY CUSTOMER 10; W_2810 <br />LOC #: <br />ADDITIONAL. REMARKS SCHEDULE Wage„ of <br />AGENCY,...,.,,..,,,.....,.,..,. <br />_..................... <br />N��yAyM�@nR INBppURPP <br />Liberty Mutual Insurance, Co, National Insurehoo West <br />PaMlcrNumdER <br />II�� gg <br />2200 EASTSTq? tOT�NTS' INC <br />ANAHEIM CA 62808 <br />WRIER <br />APV80TIVE PAM 'w <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD WORM, <br />Ana <br />Re; All Jobe performed by the named insured during the policy term <br />City of SalttA Ana, its officers, employees, agents, volunteers and representatives are <br />additional insureds with regards to general liability as their interest may appear where <br />required by written contract, <br />The insurance afforded by the OL policy for the benefit of the additional insured shall be <br />primary and non-contributory. <br />fthts <br />The ACORD name And logo are registered marks Of ACORI7 ADDENDUM <br />Y24 ROM 1 LM_2tl 19 1 1/10.9/29 . OL/2/1, ALl , WC/1. V/S I Puvnu SmItoIA, 16/0.'2/3016 0.A, 06 tAA VN (CIlt9 I Pae. 2 n`, a <br />rfvieIA vc2 %VA 10 W <br />