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AGENCY CUSTOMER ID:VERDALL-01 KMCGUFFIN <br /> LOC#: 1 <br /> ACCW LY ADDITIONAL REMARKS SCHEDULE Page 1 of 1 <br /> AGENCY NAMEDINSURED <br /> Ames Con <br /> &Gough Ve dantas Incsulking,Inc. <br /> 2600 Michelson Dr.Ste.400 <br /> POLICY NUMBER Irvine,CA 92612 <br /> SEE PAGE 1 <br /> CARRIER NAIC CODE <br /> EE PAGE 1 SEE P 1 EFFECTIVE DATE:SEE PAGE 1 <br /> ADDITIONAL REMARKS <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/LocationsNehicles: <br /> The City of Santa Ana,its officers,officials,employees,and volunteers are included as additional insured with respect to General <br /> Liability,Automobile Liability and Excess Liability when required by written contract.General Liability includes Additional Insured <br /> coverage for On-Going&Completed Operations as required by written contract.General Liability,Automobile Liability and Excess <br /> Liability are primary and non-contributory over any existing insurance and limited to liability arising out of the operations of the <br /> named insured and when required by written contract.General Liability,Automobile Liability,Excess Liability and Workers <br /> Compensation policies include a waiver of subrogation in favor of the additional insured where permissible by state law and when <br /> required by written contract.30-day Notice of Cancellation will be issued on the General Liability,Automobile Liability,Workers <br /> Compensation and Professional Liability policies in accordance with policy terms and conditions. <br /> ACORD 107(2008I01) ©2008 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />