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AGENCY CUSTOMER ID: <br /> ACC>R EP ADDITIONAL REMARKS SCHEDULE <br /> Page 1 of 2 <br /> AGENCY NAMED INSURED <br /> Cruberg Decker Insurance Services,Inc REAL ESTATE CONSULTING&SERVICES INC <br /> POLICY NUMBER 216 Avenida Fabricante <br /> San Clemente,CA 92672 <br /> 00359392 <br /> CARRIER NAIC CODE <br /> United Financial Casualty Company 11770 EFFECTIVE DATE:01/26/2026 <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 /> Additional Coverages <br /> Insurance coverage(s) Limits <br /> .........ninsured/Underinsur......................ed....Motor........ist. <br /> U ...........................$1......000.. 000............Combined..........Single..........Limit............................................................................................. <br /> , , <br /> Description of Location/Vehicles/Special Items <br /> Scheduled autos only <br /> ............................................................................................................................................................................................................ <br /> 2007 CARBON Trailer 4HXDT122X7C121407 <br /> Stated Amount $4,000 <br /> Collision $500 w/Waiver Ded <br /> Comprehensive $500 Ded <br /> ............................................................................................................................................................................................................ <br /> 2015 CHEVROLET SILVERADO C3500 1 GB3CYCG3FF678652 <br /> Stated Amount $33,805 <br /> Collision $500 w/Waiver Ded <br /> Comprehensive $500 Ded <br /> Medical Payments $1,000 each person <br /> Rental Reimbursement $40 Per Day($1,200 Max) <br /> ........................ tr'a.............................................................................................................................................................................. <br /> 2009 CONTRACT Trailer 49TCB121591093824 <br /> Stated Amount $6,000 <br /> Collision $500 w/Waiver Ded <br /> Comprehensive $500 Ded <br /> ............................................................................................................................................................................................................ <br /> 2013 CARBON Trailer4HXSU1228DC163680 <br /> Stated Amount $4,250 <br /> Collision $500 w/Waiver Ded <br /> Comprehensive $500 Ded <br /> ............................................................................................................................................................................................................ <br /> 2019 CHEVROLET SILVERADO C2500 2GB2CREG4K1230873 <br /> Stated Amount $35,000 <br /> Collision $500 w/Waiver Ded <br /> Comprehensive $500 Ded <br /> Medical Payments $1,000 each person <br /> Rental Reimbursement $40 Per Day($1,200 Max) <br /> ..................................................................................................................... <br /> 2024 CHEVROLET SILVERADO C2500 1GC4YPEY6RF166101 <br /> Collision $500 w/Waiver Ded <br /> Comprehensive $500 Ded <br /> Medical Payments $1,000 each person <br /> Rental Reimbursement $40 Per Day($1,200 Max) <br /> Roadside Assistance Selected w/$0 Ded <br /> ............................................................................................................................... <br /> 2003 FORD ECONO/CLUB WGN 1FBSS31L63HB78826 <br /> Collision $500 w/Waiver Ded <br /> Comprehensive $500 Ded <br /> Medical Payments $1,000 each person <br /> Rental Reimbursement $40 Per Day($1,200 Max) <br /> ........................................................................................................................ <br /> 2003 CHEVROLET EXPRESS G2500 1 GCGG25U631144247 <br /> Collision $500 w/Waiver Ded <br /> Comprehensive $500 Ded <br /> Medical Payments $1,000 each person <br /> Rental Reimbursement $40 Per Day($1,200 Max) <br /> ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />