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AGENCY CUSTOMER ID: <br /> LOC#: <br /> - ADDITIONAL REMARKS SCHEDULE Page 2 of 2 <br /> AGENCY NAMED INSURED <br /> AUTO CLUB INSURANCE AGENCY LLC/PHS FIVE ELEMENTS CONSULTING GROUP LLC <br /> POLICY NUMBER 8100 E TOPIA ST <br /> SEE ACORD 25 LONG BEACH CA 90808-3339 <br /> CARRIER NAIC CODE <br /> SEE ACORD 25 <br /> EFFECTIVE DATE:SEE ACORD 25 <br /> ADDITIONAL REMARKS <br /> THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM <br /> FORM NUMBER: ACORD 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE <br /> City of Santa Ana, officers, officials, employees, and volunteers but only as required by a valid written contract, agreement, or <br /> permit are additional insureds per Form SL 30 32 and Additional Insured - Owners, Lessees, or Contractors-Scheduled <br /> Person or Organization Form SL 30 48, attached to this policy. Notice of Cancellation will be provided in accordance with Form <br /> SL 90 13, attached to this policy. Coverage is primary and noncontributory per the Business Liability Coverage Form SL 00 00, <br /> attached to this policy. Waiver of Subrogation applies in favor of the Certificate Holder per Waiver of Subrogation Form SL 30 <br /> 03, attached to this policy. <br /> ACORD 101 (2014/01) 9 2014 ACORD CORPORATION.All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />