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AGENCY CUSTOMER ID: AIDSSER-01 <br /> LOC#: <br /> ,a`oRo ADDITIONAL REMARKS SCHEDULE Page 1 of 1 <br /> AGENCY NAMED INSURED <br /> CalNonprofits Insurance Services AIDS Services Foundation of Orange County, DBA: Radiant Health <br /> Centers <br /> POLICY NUMBER 17982 Sky Park Circle,Ste.J <br /> Irvine CA 92614 <br /> CARRIER 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 /> required by written contract per Endorsement Form(s)NIA-061 GL 02 19, CG 20 26 12 19& NIA-1 02 BA 01 25 attached. General Liability coverage is Primary& <br /> Non-contributory and Blanket Waiver of Subrogation applies as required by written contract per Endorsement Form(s) NIA-061 GL 02 19 and NIA-026B GL 01 <br /> 25 attached. Business Auto Liability Coverage Blanket Waiver of Subrogation applies as required by written contract per Endorsement Form(s)CA 04 44 10 13 <br /> attached.30 Day Notice of Cancellation applies per Endorsement Form NIA-064 GL 10 12 attached.Workers Compensation Waiver of Subrogation applies as <br /> required by written contract per Endorsement Form(s)WC 99 04 10 C(Ed.01-19)attached. <br /> City of Santa Ana,officers,agents,employees,and volunteers are named as additionally insured on this policy pursuant to written contract,agreement,or <br /> memorandum of understanding. Such insurance as is afforded by this policy shall be primary,and any insurance carried by City shall be excess and <br /> noncontributory. <br /> ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />