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AGENCY CUSTOMER ID: <br /> _ LOC#: <br /> '4COOR"® ADDITIONAL REMARKS SCHEDULE Page 1 of 1 <br /> AGENCY NAMED INSURED <br /> Reliance Insurance Brokers Amfasoft Corp <br /> POLICY NUMBER <br /> B7012997781,57WECGE4109 <br /> CARRIER NAIC CODE <br /> CONTINENTAL CAS CO 20443,00911 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 /> 30 days notice of cancellation except 10 days for non-payment of premium.Additional insured status,waiver of subrogation and primary and non-contributory <br /> status applies where required by written contract per the attached policy forms regarding General Liability.Waiver of subrogation applies where required by <br /> written contract regarding Workers Compensation.30 days notice of cancellation except 10 days for non-payment of premium.City of Santa Ana, its officers, <br /> employees,agents,volunteers are named as <br /> Additional Insured on this policy pursuant to written contract,agreement or memorandum of understanding.Such insurance as is afforded by this policy <br /> shall be primary and any insurance carried by the City of Santa Ana shall be excess and non contributory per endorsement.City will be mailed 30 day written <br /> notice of policy cancellation except for cancellation for non payment is 10 Day Notice <br /> ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />