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AGENCY CUSTOMER ID: XXXXXX5032 <br />ACOK" <br />ilh� <br />LOC #: — <br />ADDITIONAL REMARKS SCHEDULE <br />Page 2 of 2 <br />AGENCY <br />Bruce Johansen <br />NAMEDINSURED <br />Bragg Investment Company Inc DBA Coastline Equipment <br />POLICY NUMBER <br />2425473004 <br />CARRIER <br />Sentry Select Insurance Company <br />NAIC CODE <br />21190 <br />EFFECTIVE DATE: 10I012023 <br />ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />General Liability <br />City of Santa Ana, officers, agents, employees an volunteers are named as additionally insured on this policy <br />pursuant to written contract, agreement or memorandum of understanding. Such insurance as is afforded by this <br />policy shall be primary and any insurance carried by City shall be excess and noncontributory. GL coverage <br />provided is primary and non-contributory per the terms of endorsement CG 20 01. Commercial Excess Umbrella <br />liability coverage follows form over general liability, automobile liability and employers liability policies. See <br />attached dealers coverage form CM 88 00. Waiver of Subrogation is included. <br />ACORD 101 (2008/01) © 2008 ACORD Cl <br />2425473 The ACORD name and logo are registered marks of ACORD <br />Sentry Select Insurance Company <br />Risk memgemmtDMeivn " <br />REVIEWED&APPROVED Or. <br />Ill &a44 <br />Risk Management Specialist '. <br />UL/LU/CUL4 <br />