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AGENCY CUSTOMER ID; <br />LOC#: <br />ADDITIONAL REMARKS SCHEDULE page— of <br />AGENCY <br />BOWERMAASTER & ASSC TNS AGENCY/PHS <br />NAMED INSI3RM <br />SAM HOOPER & ASSOCIATES, INC <br />17315 EDWARDS RD STE B100 <br />CERRITQS CA 90703 <br />POLICYNUMBER <br />SEE ACCRD 25 <br />CARRIER <br />SEE ACORD 25 <br />NAICCOCE <br />EFmcmvEDAmSEE ACORD 25 <br />ADDITIONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM <br />FORMNUMSER: ACORD 25 FORMTITLE: CERTIFICATE OF LIABILITY INSURANCE <br />City of Santa Ana, its officers, employees, agents, volunteers & representatives are <br />Additional insured per the Business Liability Coverage Form SS0008. Coverage is <br />primary & non-contributory per the Business Liability Coverage Form SS0008.Notice of <br />cancellation will be provided in accordance with Form SS1223 attached to this policy. <br />ACORD 101 (2014101) 0 2014 ACORD CORPORATION. All rights reserved. <br />Fhe AGORD name and logo are registered marks of ACORD <br />