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178504 Servando Varela Dba Xv Solutions Certificate of Insurance Page (z ofz) 7/7/2020 3:02:40 PM <br />AGENCY CUSTOMER ID: 178504 <br />LOC #: <br />msureon <br />ADDITIONAL REMARKS SCHEDULE <br />Page 1 of 1 <br />AGENCY <br />NAMED INSURED <br />Servando Varela Dba. Xv Solutions <br />Po Box 28373 <br />Santa Ana, CA 92799 <br />POLICY NUMBER <br />CARRIER <br />NAIC CODE <br />EFFECTIVE DATE: <br />ADDITIONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: ACORD 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE <br />City of Santa Ana, its officers, employees, agents and representatives are Additional Insureds with respect to General Liability and Auto Liability per the attached <br />endorsements or as required by written contract.This insurance is primary and non-contributory to any other insurance provided as respects general liability <br />coverage.Should any of the above described policies be cancelled before the expiration date, the issuing insurer will endeavor to mail 30 days written notice (10 <br />days notice if due to non-payment) to the certificate holder named below, but failure to do so shall impose no obligation or liability of any kind upon the insurer, its <br />agents or representatives. For all policies listed above, cancellation notice provisions are located in your policy documents. Please refer to those documents for <br />information pertaining to notification of certificate holders when a policy is cancelled before the expiration date. <br />ACORD 101 (2008/01) © 2008 ACORD C <br />The ACORD name and logo are registered marks of ACORD <br />Rime ManagementDia II <br />rREmEWED&{ PPRcyvED BYBy., <br />ram. o_l lliJ _II.IPJ-z' rAs6HlM�e V&E44d <br />® Risk Management Analyst <br />