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AGENCY CUSTOMER ID: ADRSERV-01 <br />BMITROSILIS <br />7 <br />ACORO' <br />11�1� <br />LOC #: 1 <br />ADDITIONAL REMARKS SCHEDULE <br />Page 1 of 1 <br />AGENCY <br />License # 0633339 <br />NAMED INSURED <br />Olson Duncan Insurance Service Inc. <br />ADR Services, Inc. <br />1900 Avenue of the Stars # 200 <br />Los Angeles, CA 90067 <br />POLICY NUMBER <br />SEE PAGE 1 <br />- <br />CARRIER <br />NAIC CODE <br />EE PAGE 1 <br />SEE P 1 <br />EFFECTIVE DATE: SEE PAGE 1 <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance <br />Description of Operations/LocationsNehicles: <br />Policy terms apply. <br />ACORD 101 (2008101) © 2008 ACORD CC <br />The ACORD name and logo are registered marks of ACORD <br />Rill Maraigeriard DMdon <br />�- REVIEWED/&APPROVEDBY: <br />-smi-i—e�L t•I6� f rlGlUk�O <br />�'. <br />Risk management specialist ' <br />