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AGENCY CUSTOMER IM 1005974 <br />LOC #'. <br />ACC>RV <br />ADDITIONAL REMARKS SCHEDULE <br />Page of <br />AGENCY <br />NAMED INSURED <br />SL Insurance Associates Ina <br />Pacific services Inc <br />dba: Pacific Datacom <br />POLICY NUMBER <br />927 Calls Negocic Ste L <br />San Clemente, CA 92673 <br />CARRIER <br />NAIC CODE <br />EFFECTIVE DATE: <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: Corti f icate of Liability insurance <br />CERTIFICATE NUMBER: REVISION NUMBER: <br />'30 Days notice of Cancellation* *10 day notice for Non-pay <br />1149KOWDIF <br />©200B ACORD <br />The ACORD name and logo are registered marks of ACORD Ivelo.-OwAro <br />