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AGENCY CUSTOMER ID: ORANCOU-19 <br />LOC #: <br />ACOR" ---- --- <br />lk.� ADDITIONAL REMARKS SCHEDULE <br />AGENCY Page 1 of <br />Arthur J. Gallagher & Co, NAMED INSURED <br />Orange County Conservation Corps <br />POLICY NUMBER 1853 N. Raymond Ave. <br />Anaheim, CA 92801 <br />CARRIER <br />NAI]CODE <br />ADDITIONAL REMARKS FFECTIVE DATE: <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE <br />'he City of Santa Ana, its officers, employees, agents, volunteers and representatives are named as named additional insured with respect to the operations of <br />ie named insured. The Insurance provided in the General Liabilityy primary ritten <br />otice shall be provided at least ten (10) days In advance of cancelatioln for non-pam non -Payment of premium and thirty (30) dayinsurance shall be s advaanand ce or any other anc�ation <br />other , <br />r policy change. <br />ACORD 101 (2008/01) ,ell ae KnfcM�reBeD��tDiWeion <br />REVIEWED F APPRCIVED BY: <br />The ACORD Hama �...i �„__ ___ ... 0 2008 ACORD C i ?' . �nsw.�.!... A I/•!E__ _E <br />