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FULL AGENDA PACKET 2021-07-06
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FULL AGENDA PACKET 2021-07-06
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7/12/2021 12:33:17 PM
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7/12/2021 9:06:53 AM
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City Clerk
Doc Type
Agenda Packet
Agency
Clerk of the Council
Date
7/6/2021
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AGENCY CUSTOMER 10: ORANCOU-19 <br />EXHIBIT 2 <br />LOC #: <br />ADDITIONAL REMARKS SCHEDULE <br />Page 1 of 1 <br />AGENCY <br />Arthur J. Gallagher & Co. <br />NAMEDINBDRED <br />Orange County Conservation Corps <br />1853 N. Raymond Ave. <br />Anaheim, CA 92801 <br />POLICY NUMBER <br />.......................................... <br />CARRIER NAIC CODE <br />AFFECTIVE DATE: <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 28 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE <br />named insured. The insurance provided In the Garen <br />tice shall be provided at least ten (10) days in advance <br />policy change. <br />ACORD <br />r is primary and any other Insurance shall be excess only, and not contributing. Written <br />for non-payment of pramiun and thirty (30) days In advance for any other cancollatlon <br />@ 2008 ACORD CI <br />The ACORD name and logo are registered marks of ACORD <br />f PJA Mma&sm tDirisim <br />U pBAY <br />A PROVED BY <br />1r MA z (Fat".4ad <br />Rtxk t4tannupy lent Analyst <br />
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