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AGENCY CUSTOMER ID:BRAISTU-01 LBOSSHART <br /> Lae#: 1 <br /> A a' -- <br /> ADDITIONAL REMARKS SCHEDULE Page 1 of 1 <br /> AGENCY License#0M10410 NAMED INSURED <br /> rmstron ]Robitaille/Rie le Business and Insurance Solutions Brainstorm Studios, LLC <br /> g g 42 Waterworks Way <br /> POLICYNUMBER Irvine,CA 92618 <br /> EE 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 Liabift Insurance <br /> Description of Operations]LocationsfVehicles: <br /> The City of Santa Ana, its officers, officials, employees, and volunteers are to be covered as additional insureds on the CGL policy <br /> with respect to liability arising out of work or operations performed by or on behalf of the Permittee including materials, parts, or <br /> equipment furnished in connection with such work or operations, Primary& Non-Contributory coverage and a Waiver of <br /> Subrogation applies to the General Liability policy per the attached forms. <br /> ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved.. <br /> The ACORD name and logo are registered marks of ACORD <br />