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AGENCY CUSTOMER ID: RINCCON-01 PHILLIPSC <br />LOC <br />ACC)RD <br />ADDITIONAL REMARKS SCHEDULE Page 1 of I <br />AGENCY License # OF -677681 NAMED INSURED <br />Legends Environmental Ins, Services Rincon Consultants, Inc. <br />.____,j210NAshwoodAv <br />POLICY NUMBER Ventura, CA 93033 <br />SEE PAGE I <br />CARRIERNAIC CODE <br />SEE PAGE I iSEE P 1 EPFECTIVE DATEa <br />SEE PAGE 1.__ <br />ALIUMU - NALKLMARKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: -AC-ORD 25 FORM TITLE: CertificateofLlabilty-lns.yrap.ce <br />Description of Operations/Locations/Vehicles: <br />Auto Liability and Workers Compensation as required by written contract, per Endorsement CG 24 04 10 93, HA99160312 <br />WC000313. Excess policy follows General Liability, Auto Liability and Employers Liablility form. <br />I t4wWD'u I I i9;eUU8 Ak;VKL) k;UKPQRA I'ION, All rights reserved, <br />The ACORD name and logo are registered marks of ACORD <br />