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AGENCY CUSTOMER ID: MARKT-1 <br />LOC #: <br />A� ADDITIONAL REMARKS SCHEDULE <br />Page —of <br />AGENCY <br />Asero Insurance Services <br />NAMEDINSURED <br />Mark Thomas & Company, Inc. <br />2833 Junction Avenue, Ste 110 <br />San Jose CA 95134 <br />POLICY NUMBER <br />CARRIER <br />NAIC CDDE <br />EFFECTIVE DATE: <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: Certificate of Liability (03/16) <br />HOLDER: City of Santa Ana Risk Management Division <br />ADDRESS: 20 Civic Center Plaza Santa Ana, CA 92702 _ <br />Commercial General Liability Blanket Additional Insured - Owners, Lessees Or Contractors - <br />With Products -Completed Operations Coverage Endorsement and Primary and Noncontributory <br />Insurance as required by written contract per attached from CNA75079XX (10-16). <br />Commercial General Liability Waiver Of Transfer Of Rights Of Recovery Against Others To <br />The Insurer Endorsement as required by written contract per attached form CNA75008XX <br />(10-16). <br />Commercial Auto Liability Additional Insured - Primary And Non -Contributory as required by <br />written contract per attached form CNA71527XX (Ed. 10/12). <br />Commercial Auto Liability Waiver Of Transfer Of Rights Of Recovery Against Others To Us <br />(Waiver Of Subrogation) as required by written contract per attached form CA 04 44 10 13. <br />Workers' Compensation Blanket Waiver Of Our Right To Recover From Others as required <br />by written contract per attached form G-19160-B (Ed. 11/97). <br />*Subject To Policies Terms, Conditions, and Exclusions <br />© 2008 A <br />The ACORD name and logo are registered marks of ACORD <br />REVIEWED &DAPPRO��V9(ED I3y�:: <br />tl, RBk Management Analyst <br />57714801 1 MARKP-1 120-21 M. ter Certificate I Prabhjot Mar 1 9/23/2020 2:39:23 PM (PDT) I Page 2 of 11 <br />