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AGENCY CUSTOMER ID: JLEEENG-01 <br />LOC #: <br />YLIENG <br />AFRO <br />ADDITIONAL REMARKS SCHEDULE <br />Page 1 of 1 <br />AGENCY <br />License # OE67788 <br />NAMED INSURED <br />IOA Insurance Services <br />JLee Engineering, Inc. <br />430 S. Garfield Avenue, #301 <br />Alhambra, CA 91801 <br />POLICY NUMBER <br />SEE PAGE 1 <br />CARRIER <br />NAIC CODE <br />SEE PAGE 1 <br />SEE P 1 <br />EFFECTIVE DATE: SEE PAGE 1 <br />rSPJYlr LLU1Cr9■ <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance <br />Description of Operations/Locations/Vehicles: <br />authorized agents <br />CANCELLATION NOTICE: 30 days written notice is provided to the aforementioned Certificate Holder. <br />RBE IIEWM D & APPRNFqEMENTpOV oD <br />RO <br />IL <br />AGURD 1131 (2UU3IUI) © 2008 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />