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25A - AGMT WIOA FORMULA
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25A - AGMT WIOA FORMULA
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Last modified
6/27/2019 5:16:41 PM
Creation date
6/27/2019 5:05:21 PM
Metadata
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Community Development
Item #
25A
Date
7/2/2019
Destruction Year
2024
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EXHIBIT 3 <br />AC 7 L> <br />AGENCY <br />Achur J, GGIla9her d Co. <br />POLICY NUGEER <br />CAIiRIeR <br />AGENCY CUSTOMER ID: ORANCOU-19 _ <br />LOC 0: <br />AnnIT1ONa1_RFMARK53CH1=1 iv F <br />NAIL CGGE <br />NAMED INSUME) <br />0,ango County Consarvatinn Cerps <br />1853 N. Raymond Ave. <br />Anaheim- CA 92801 <br />Page i of <br />THIS ADDITIONAL REMARKS FORM 19 A SCHEDULE TO ACORO FORM, j <br />FORM NUMBER: 25 FORM TITLE: CER1IRGATt OF LIAWLIIY INSURANCE 11 <br />Insurance Co, NAIL: 20832 <br />s ofFioars, agents, employes and velar-Wrs, and the Stateot CaOfmnla, Its of9uays, employees, and volcntGors are named addilional <br />with respocfto the operations of the named insured per the n!tached GO 2026 endorsement. Such insviance is Primary and <br />:raCompensation coverage evidence only. <br />The AGORO name and logo are registered marks of ACORO <br />25A-307 <br />
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