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AGENCY CUSTOMER ID: 00000011 <br /> LOC#: <br /> ADDITIONAL REMARKS SCHEDULE Page of <br /> AGENCY NAMED INSURED <br /> Scott&McCauley Insurance Agency EBS GENERAL ENGINEERING,INC <br /> POLICY NUMBER <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 /> Contractors Equipment policy. <br /> Risk Managanent DMsbn <br /> �?- REVIEWED&APPRCYVED BY: <br /> ® Risk P.1anagement Specialist <br /> ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />