Laserfiche WebLink
ACORD_ <br />AGENCY CUSTOMER ID: <br />LOC X: <br />AI ni-r1(ANAI 1?5=RAAF2KC 11 c <br />Page of <br />AGENCY <br />NAMED INSURED <br />Insurance Office of America, Inc. <br />Scott Fazekas & Associates, Inc. <br />Irvine, CA 92606 <br />POLICY NUMBER <br />CARRIER NAIL CODE <br />EFFECTIVE DATE: <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: ACORD Certificate of Liability Insurance <br />Garage Liability <br />(NSR <br />LTR INSRD NSRD POLICY EFFECTIVE POLICY EXPIRATION <br />POLICY NUMBER DATE (MM/DD/YY) DATE (MM/DD/YY) LIMITS <br />AUTO ONLY - EA ACCIDENT $ <br />ANY AUTO <br />OTHER THAN EA ACC $ <br />AUTO ONLY: AGG $ <br />IAutoniobile Liability <br />INSR ADD -L POLICY EFFECTNE POLICY EXPIRATION <br />LTR INSRD POLICY NUMBER DATE (MM/DD/YY) DATE (MM/DD/YY) <br />A <br />Excess/Umbrella Liability <br />INSR ADD -I- POLICY EFFECTIVE POLICY EXPIRATION <br />LTR INSRD POLICY NUMBER DATE (MM/DD/YY) DATE (MM/DD/YY) <br />A <br />(Other Liability <br />POLICY EFFECTE POLICY EXPIRATION <br />LTR N <br />C POLICY NUMBER DATE (MM/DD/YY) DATE (MM/DD/YY) <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES <br />certificate holders and additional insured per the attached endorsment. <br />rhe ACORD name and logo are registered marks of ACORD <br />LIMITS <br />$ <br />LIMITS <br />