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AGENCY CUSTOMER ID: <br />LOC #.' <br />L- O® ADDITIONAL REMARKS SCHEDULE Page of <br />AGENCY <br />Pacific Agents Alliance Insurance Agency: <br />Julie Traughber Insurance Agenc <br />NAMED INSURED <br />Argo Enterprises, Inc. dba: UniShield <br />POLICY NUMBER <br />CARRIER <br />NAIC CODE <br />EFFECTIVE DATE: <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insuram <br />email: korozco@sante-ana.org <br />ACORD 101 f2008f011 <br />The ACORD name and logo are registered marks of ACORD <br />RideMwcgoncrIDi olon <br />s REV eE & APPROVEDBY: <br />FAA+'O� D vs-4 4a <br />® Risk Management Analyst <br />