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AGENCY CUSTOMER ID: CALIFORPRO <br />A� )®0 ADDITIONAL REMARKS SCHEDULE <br />CARLOSD <br />Page 1 of 1 <br />AGENCY <br />License# 0252036 <br />NAMED INSURED <br />California Inc. <br />United Agencies <br />1Jose AvenueEngineering <br />La Puente, CA 91748 <br />POLICY NUMBER <br />EE PAGE 1 <br />------ <br />------------------------- <br />CARRIER <br />------- <br />NAIC CODE <br />EE PAGE 1 <br />SEE P 1 <br />EFFECTIVE DATE: S <br />ADDITIONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: ACORD 26 FORM TITLE: Certificate of Liabitity_In—suranee <br />Description of OperationslLocationsNehicles: <br />*With resepect to the additional insureds (the City of Santa Ana, its officers, employees, agents, and volunteers), this Insurance shall <br />not be cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of <br />Santa Ana, Public Works Agency, 20 Civic Center Plaza, Ross Annex, M-93, Santa Ana, CA 92701, <br />gym.. RkkMmPg+e LDlvisIm <br />REVIEWED&APPROVEDB <br />ACORD 101(2008101) 02008ACORDCO I <br />®" RI%ic WrlageMVOt APOIYAt01 <br />The ACORD name and logo are registered marks of ACORD <br />