Laserfiche WebLink
AGENCY CUSTOMER ID: <br />LOC: #: <br />7 � <br />ADDITIONAL REMARKS SCHEDULE <br />ICY NAMEDINSURED <br />Barrett Business Services, Inc. <br />Int Underwriting Inc. 8100 NE Parkway, Suite 200 <br />'Y NUMBER Vancouver WA 98662 <br />C48533085 <br />;IER NAIC CODE <br />Page 2 of 2 <br />IACE American Insurance Company 122667 IEFFECTIVE DATE: 10/01/15 I <br />ADDITIONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: Certificate of Liability (01114) <br />CERTIFICATE HOLDER: City of Santa Ana <br />ADDRESS: 20 Civic Center Plaza Santa Ana CA 92701 <br />The City of Santa Ana; 30 Day Cancellation Notice <br />ACORD 101 (2008101) c) 1988 -2010 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD. <br />