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AGENCY CUSTOMER ID: 00064361 <br />LOC #: <br />Ac�o!zo® ADDITIONAL REMARKS SCHEDULE Page 2 of <br />AGENCY <br />NAMED INSURED <br />Palm Valley Insurance <br />Vicente Martinez <br />DBA: Premier Pest Services West <br />POLICY NUMBER <br />MP0004010006031 <br />CARRIER <br />NAIC CODE <br />Mesa Underwriters Specialty Ins Co <br />EFFECTIVE DATE:08/07/2021 <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 />(continued from Description of Operations) <br />30 Days Notice of Cancellation with 10 days Notice of Non-payment of premium In accordance with the policy provisions. <br />ACORD 101 (2008/01) © 2008 ACORD CI csa managemenuenca rune <br />The ACORD name and logo are registered marks of ACORD <br />Printed by ANN on November 10, 2021 at 08:49AM <br />