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FORM NUMBER: <br />EFFECTIVE DATE: <br />The ACORD name and logo are registered marks of ACORD <br />ADDITIONAL REMARKS <br />ADDITIONAL REMARKS SCHEDULE <br />FORM TITLE: <br />Page of <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />ACORD 101 (2008/01) <br />AGENCY CUSTOMER ID: <br />LOC #: <br />AGENCY NAMED INSURED <br />POLICY NUMBER <br />CARRIER NAIC CODE <br />© 2008 ACORD CORPORATION. All rights reserved. <br />IOA Insurance Services <br />WESTYOS-01 <br />SEE PAGE 1 <br />1 <br />SEE PAGE 1 <br />ACORD 25 Certificate of Liability Insurance <br />License # 0E67768 <br />1 <br />SEE P 1 <br />West Yost & Associates, Inc. <br />2020 Research Park Drive <br />Suite 100 <br />Davis, CA 95618 <br />SEE PAGE 1 <br />MICHAELA <br />1 <br />Description of Operations/Locations/Vehicles: <br />Auto Liability: The City of Pleasanton, its officers, employees and appointed agents is included as Additional Insured with Waiver of <br />Subrogation included, as required by written contract. <br />*30-Day Notice of Cancellation are included in accordance with policy provisions <br />DocuSign Envelope ID: BFF1438E-3012-40E2-B105-DC4858C15F09