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DAVITAU-01LBURRILL <br />AGENCY CUSTOMER ID: <br />1 <br />LOC #: <br />Page of <br />11 <br />ADDITIONAL REMARKS SCHEDULE <br />AGENCYNAMED INSURED <br />David Taussig & Associates Inc. <br />Acrisure Southwest Partners Insurance Services, LLC <br />dba DTA <br />18201 Von Karman Ave <br />POLICY NUMBER <br />Suite 220 <br />SEE PAGE 1 <br />Newport Beach, CA 92612 <br />CARRIERNAIC CODE <br />SEE PAGE 1SEE P 1 <br />EFFECTIVE DATE: <br />SEE PAGE 1 <br />ADDITIONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />ACORD 25Certificate of Liability Insurance <br />FORM NUMBER:FORM TITLE: <br />Description of Operations/Locations/Vehicles: <br />THE CITY OF SANTA ANA, IT'S OFFICERS, EMPLOYEES, AGENTS, AND REPRESENTATIVE ARE NAMED AS ADDITIONAL INSURED <br />IN REGARDS TO GENERAL LIABILITY. <br />-A/I ATTACHED. <br />ACORD 101 (2008/01)© 2008 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br /> <br />