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ACC?RO' <br />AGENCY CUSTOMER ID: NBSGOVE-01 <br />LOC #: 1 <br />ADDITIONAL REMARKS SCHEDULE <br />SEIME1 <br />Page 1 of 1 <br />AGENCY <br />License# OL48969 <br />NAMED INSURED <br />3 Risk & Insurance Services <br />NBS Government Finance Group <br />32605 Temecula Parkway, Suite 100 <br />Temecula, CA 92592 <br />POLICY NUMBER <br />EE PAGE 1 <br />CARRIER <br />NAIC CODE <br />EE PAGE 1 <br />SEE P 1 <br />EFFECTIVE DATE: SEE PAGE 1 <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/LocatlonsNehicles: <br />AUTO: <br />Additional Insured: 461-0478 12 12 <br />Primary & Non -Contributory: 461-0478 12 12 <br />Waiver of Subrogation: 461-0155 9 97 <br />WORKERS' COMPENSATION: <br />Waiver of Subrogation: WC040306 4-84 <br />*In the event of cancellation, 30 days notice (10 days for nonpayment) will be issued according to policy provisions. <br />ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />