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AGENCY CUSTOMER ID: <br />LOC #: <br />ADDITIONAL REMARKS SCHEDULE Page 1 of 1 <br />AGENCY NAMED INSURED <br />Arthur J. Gallagher & Co. Orange County Conservation Corps <br />-- 1853 N. Raymond Ave. <br />POLICY NUMBER Anaheim, CA 92801 <br />CARRIER NAIC CODE <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 INSURANCE <br />Policy : Professional Liability <br />Policy #: PAC 5154680 13 <br />Carrier :Great American Alliance Insurance Co NAIC: 26832 <br />Term: 10/01 /2017 -10101 /2018 <br />Each Occ : 1,000,000 <br />Aggregate : 3,000,000 <br />The City of Santa Ana, its officers, agents, employees and volunteers, and the State of California, its officers, employees, and volunteers are <br />named additional insured/Funding Source with respect to the operations of the named insured per the attached CG 202E endorsement. Such <br />insurance is Primary and Non -Contributory. Workers Compensation coverage excluded, evidence only. <br />ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved <br />The ACORD name and logo are registered marks of ACORD <br />