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AGENCY CUSTOMER ID: <br /> _ LOC#: <br /> A`COR O® ADDITIONAL REMARKS SCHEDULE Page 2 of <br /> AGENCY NAMED INSURED <br /> EZ Insurance Services, Inc CABIFORNIA INC. <br /> POLICY NUMBER <br /> NIA <br /> CARRIER NAIC CODE <br /> Multiple Carriers 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 /> Vehicles Summary <br /> # Year Make Model VIN Fleet ID Co Vehicle# <br /> Locations Summary <br /> Loc# Description Address <br /> Location 1 General Contractor 26611 NACCOME DR MISSION VIEJO,CA 9269 <br /> Building 1 General Contractor <br /> ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD j <br /> Printed by AAS on September 09,2025 at 08:38AM <br />