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AGENCY CUSTOMER ID: MxnKT-1 <br />ADDITIONAL REMARKS SCHEDULE Page of <br />AGENCY <br />Asero Insurance Services <br />NAMED INSURED <br />Mark Thomas & Compa% Inc. <br />2290 North First Street, uite 304 <br />San Jose CA 95131 <br />POLICY NUMBER <br />CARRIER <br />T�i <br />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 (03/16) <br />HOLDER: City of Santa Ana <br />ADDRESS: 20 Civic Center Plaza Santa Ana CA 92702 <br />General Liability Waiver of Subrogation / Primary & Non -Contributory <br />as required by written contract per Inzm CG o3 81 Og 07 <br />Commercial Auto Liability Additional Insured / Waiver of Subrogation as required by <br />written contract per form ca rj 53 03 10 <br />Workers' Compensation Waiver of Subrogation as required by written contract per form WC OO <br />03 13 (00} <br />General Liability Additional Insured perform CG201O1001 <br />Acomm1o1poomo1> @ 20OuACORoCORPORATION. All rights reserved. <br />The ACOmoname and logo are registered marks ofACDRD ATrAonmswr <br />