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ACORD,, <br />AGENCY CUSTOMER ID: <br />LOC #: <br />ADDITIONAL REMARKS SCHEDULE <br />Page of <br />AGENCY NAMED INSURED <br />Insurance Office of America, Inc. Gillis & Panichapan Architects, Incorporated <br />POLICY NUMBER Costa Mesa, CA 92626 <br />CARRIER NAIC CODE <br />EFFECTIVE DATE: <br />:)ITIONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORMTITLE:ACORD Certificate of Liability Insurance <br />Garage Liability <br />(INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION <br />LTR INSRD POLICY NUMBER DATE (MM/DD/YY) DATE (MM/DD/YY) LIMITS <br />AUTO ONLY - EA ACCIDENT $ <br />ANY AUTO <br />Automobile Liability <br />INSR ADD'L <br />LTR INSRD POLICY NUMBER <br />A <br />POLICY EFFECTIVE POLICY EXPIRATION <br />DATE (MM/DD/YY) DATE (MM/DD/YY) <br />OTHER THAN EA ACC $ <br />AUTO ONLY: AGG $ <br />Excess/Umbrella Liability <br />INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION <br />LTR INSRD POLICY NUMBER DATE (MM/DD/YY) DATE (MM/DD/YY) LIMITS <br />A $ <br />Other Liability <br />INSR POLICY EFFECTIVE POLICY EXPIRATION <br />LTR POLICY NUMBER DATE (MMIDDIYY) DATE (MMIDD/YY) LIMITS <br />B <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES <br />:ORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserve <br />The ACORD name and logo are registered marks of ACORD <br />