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AGENCY CUSTOMER ID: <br />LOCI{: <br />ADDITIONAL REMARKS SCHEDULE <br />Page 2 of 2 <br />BIN INSURANCE HOLDINGS LLC/PHS <br />SEE ACORD 25 <br />CARRIER NAIC CODE <br />SEE ACORD 25 <br />NAMED <br />PROUDCITY INC <br />2219 DAMUTH ST <br />OAKLAND CA 94602-2411 <br />EFFECTIVE DATE; SEE ACORD 25 <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM <br />FORM NUMBER: ACORD 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE <br />City of Santa Ana, officers, agents, employees, and volunteers are named as additionally insured is an additional insured per <br />Additional Insured: Owners, Lessees, or Contractors; Scheduled Person or Organization Form SS4170 attached to this policy <br />Coverage is primary and noncontributory per the Business Liability Coverage Form SS0008, attached to this policy. Notice of <br />Cancellation will be provided in accordance with Form SS1223, attached to this policy. <br />�� IEwEo&APPRo eo Byl: <br />� ��� tt�lEW@1t A°PRCIV@Bri <br />ACORD 101 (2014101) © 2014 ACORD CORPOR Y ( ' li A i'i A <br />The ACORD name and logo are registered marks of ACORD ®` Polak Management supeivlsor <br />