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^ AGENCY CUSTOMER ID: JAMIENG-01 SGIONZALEZ <br />LOC <br />A��" ADDITIONAL REMARKS SCHEDULE <br />Page 1 of 1 <br />AGENCY <br />License # 07577761 <br />NAMED INSURED <br />iUB International Insurance Services Inc. <br />Jamison Engineering Contractors Inc. <br />2525 S. Yale St. <br />POLICY NUMBER <br />-- _ Santa Ana, CA 92704 <br />3EE PAGE 1 <br />CARRIER <br />NAIC CODE <br />3EE PAGE 1 <br />iSEE P 1 EFFECTIVE DATE: SEEPAGE 1 <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 />contract per the attached endorsement form 2572. <br />Should the policies be cancelled before the expiration date, Hub International Insurance Services Inc. (Hub), independent of any <br />rights which may be afforded within the policies to the certificate holder named below, will provide to such certificate holder notice <br />of such cancellation within thirty (30) days of the cancellation date, except in the event the cancellation is due to non-payment of <br />premium, in which case Hub will provide to such certificate holder notice of such cancellation within ten (10) days of the cancellation <br />date. <br />Rkk Morg,nntDM <br />IRinEroID6/IPPflOvBJ BY: , <br />ACORD 101 (2008/01) © 2008 ACORD CORP( ioa rwuoa <br />"imp <br />The ACORD name and logo are registered marks of ACORD RiskANna9=n=„mmmlaae <br />