Laserfiche WebLink
AGENCY CUSTOMER ID: M <br />LOC p: <br />A� ADDITIONAL REMARKS SCHEDULE <br />Page 1 of 1 <br />AGENCY <br />Burnham WGB Insurance Solutions <br />NAMED INSURED <br />Mercy House Living Centers, Inc. <br />PO Box 1905 <br />Santa Ana CA 92702 <br />POLICY NUMBER <br />CARRIER <br />NAIC CODE <br />EFFECTIVE DATE: <br />ADDITIONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE <br />Re: <br />All Operations usual to the insured's operations subject to the policy terms and conditions. <br />CERTIFICATE HOLDER VESTING: City of Santa Ana, its officers, employees, agents and representatives <br />tli,_ WvtwFnG AwRw®Br. <br />li 7a a <br />ACORD 101 (2008101) © 2008 ACORD C( <br />The ACORD name and logo are registered marks of ACORD <br />