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AGENCY CUSTOMER ID: <br />LOC#: <br />ADDITIONAL REMARKS SCHEDULE Page of <br />AGENCY <br />BIN INSURANCE HOLDINGS LLC/PHS <br />NAMED INSURED <br />HJELMSTROM & <br />25072 WILKES <br />LAGUNA HILLS <br />ASSOCIATES <br />PL <br />CA 92653 <br />POLICY NUMBER <br />SEE ACORD 25 <br />CARRIER <br />SEE ACORD 25 <br />NAIC CODE <br />EFFECTIVE DATE: SEE <br />ACORD 25 <br />ADDITIONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM <br />FORIVINUMBER: ACORD 25 FORIVITITLE: CERTIFICATE OF LIABILITY INSURANCE <br />Those usual to the Insured's Operations. The City of Santa Ana, 20 Civic Center <br />Plaza, Santa Ana, California 92701; its officers, employees, agents, volunteers and <br />representatives are named as additional insureds ("additional insureds") with regard <br />to liability and defense of suits arising from the operations and uses performed by <br />or on behalf of the named insured. With respect to claims arising out of the <br />operations and uses performed by or on behalf of the named insured, such insurance as <br />is afforded by this policy is primary and is not additional to or contributing with <br />any other insurance carried by or for the benefit of the additional insureds. This <br />insurance applies separately to each insured against whom claim is made or suit is <br />brought except with respect to the company's limits of liability.The inclusion of any <br />person or organization as an insured shall not affect any right which such person or <br />organization would have as a claimant if not so included. With respect to the <br />additional insureds, this insurance shall not be cancelled after thirty (30) days <br />written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa <br />Ana, California 92701. Severability of Interest Insurance applies separately to each <br />interest against whom claim is made or suit is brought per the Business Liability <br />Coverage Form SS00080405 attached to this policy. <br />ACORD 101 (2014101) @ 2014 ACORD CORPORATION. All riaht,; rP-qPrvPrI <br />The ACORD name and logo are registered marks of ACORD <br />REVIEWED B <br />-'.UNi(.",E HERE IMP A (PG OF <br />