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AGENCY CUSTOMER ID: DISCCUB-01 <br /> LOC#: <br /> AC V ADDITIONAL REMARKS SCHEDULE Page 1 of 1 <br /> L� <br /> AGENCY NAMED INSURED <br /> Gaspar Insurance Services, Inc, Discovery Science Center Of Orange County dba Discovery Cube <br /> Orange County <br /> POLICY NUMBER 2500 N Main Street <br /> Santa Ana CA 92705 <br /> CARRIER NAIC CODE <br /> 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 /> written notice to the City.*10 days notice for non-payment of premium. <br /> City of Santa Ana,officers,agents,employees,and volunteers are afforded additional insured status as per the embedded coverages found in the coverage <br /> forms when required by written contract,agreement or permit but only as respects to the liability of the insured,pursuant to the terms,conditions,limitations and <br /> exclusions of the listed policies. Coverage for the Business Auto and General Liability is on a Primary&Non-Contributory basis. Waiver of Subrogation applies <br /> in favor of the additional insured. <br /> Umbrella is follow-form and comes down over the underlying General Liability,Auto and Workers Compensation coverage. <br /> ACORD 101 (2008/01) 02008 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />