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AGENCY CUSTOMER ID: PAYOKAA-01 MSOTO2 <br /> LOC#: <br /> ACORE7ADDITIONAL REMARKS SCHEDULE Page 1 of 1 <br /> AGENCY License#OC36861 NAMED INSURED <br /> Irvine-Alliant Insurance Services, Inc. PAYOMKAWICHUM KAAMALAM:THE WESTERNER-FIRST PEOPLE OF <br /> EARTH MOTHER <br /> POLICY NUMBER 4955 PASEO SEGOVIA <br /> SEE PAGE 1 IRVINE,CA 92603 <br /> CARRIER NAIL CODE <br /> SEE 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 /> As respects service agreement for Native American Monitoring for the New Park Construction Project at 10th Street&Flower Street <br /> in the City of Santa Ana CA. City of Santa Ana, its City Council,its officers,officials,employees,agents, and volunteers are named <br /> as additional insured as respects general liability only arising out of the operations by or on behalf of the named insured. <br /> The terms"participating named insured"and "insured"are used severally and not collectively, but the inclusion herein of more than <br /> one"participating named insured"or"insured shall not operate to increase the limits of the"company's"liability. <br /> The"Company" may cancel the coverage provided to the "Participating Named Insured", by mailing to the first"Participating Named <br /> Insured"at the address shown in the Declaration Page written notice stating when, not less than sixty (60)days thereafter, such <br /> cancellation shall be effective. Provided that the"Participating Named Insured"fails to discharge,when due,any of its obligations <br /> in connection with the payment of premium for the policy or any installment thereof,whether payable directly to the "Company"or <br /> its agent or indirectly under a premium finance plan or extension of credit,the coverage provided to the"Participating Named <br /> Insured"may be canceled by the"Company" by mailing to the "Participating Named Insured" at the address shown in the <br /> Declaration Page,written notice stating when, not less than ten(10)days thereafter, such cancellation shall be effective. <br /> ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />