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AGENCY CUSTOMER ID: OLIVCRE-01 <br />LOC #: <br />SLANZAS <br />AC®RO� <br />ADDITIONAL REMARKS SCHEDULE <br />Page 1 of 1 <br />AGENCY <br />License#0757770 <br />NAMEDINSURED <br />HUB International Insurance Services Inc. <br />Olive Crest <br />2130 East Fourth St, Suite 200 <br />Santa Ana, CA 92705 <br />POLICY NUMBER <br />EE PAGE 1 <br />CARRIER <br />NAIC CODE <br />EE PAGE 1 <br />SEE P 1 <br />EFFECTIVE DATE: SEE <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Llabllity Insurance <br />Description of Operations/Locations/Vehicles: <br />the cancellation date, except in the event the cancellation Is due to non-payment of premium, in which case HUB will provide to such <br />Certificate Holder notice of such cancellation within ten (10) days of the cancellation date. <br />ACORD 101 <br />© 2008 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />