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AGENCY CUSTOMER ID: CN102330351 <br />LOC #: Irvine <br />ADDITIONAL REMARKS SCHEDULE Page 2 & 2 <br />AGENCY — <br />Marsh Risk & Insurance Services <br />POLICY NUMBER <br />CARRIER <br />NAIC CODE <br />NAMED INSURED <br />Econolite Systems, Inc. <br />1250 N. Tustin Avenue <br />Anaheim, CA 92807 <br />EFFECTIVE DATE: <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 />If the calnercancels the General liability, Aub Liability, or Workers Compensation for any statutorily pemtiued reason ogler than nonpaymam of premium, and a number of days Is <br />shown forcancellatbn in the schedule, the camierwill mail notice of cancellation to the person or organization shorn in the schedule. The carver wir mail such notice b the address <br />shown in the schedule at least 30 days behove the effective data of cancellation. Endorsement to follow. <br />ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. <br />T e ACORn ------ __ _ . _ ____ <br />a •••••�•• n:u, n� v, IIYVRV <br />