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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 />C3 Risk & Insurance Services <br />NBSGOVE-01 <br />SEE PAGE 1 <br />1 <br />SEE PAGE 1 <br />ACORD 25 Certificate of Liability Insurance <br />License # 0L48969 <br />1 <br />SEE P 1 <br />NBS Government Finance Group <br />32605 Temecula Parkway, Suite 100 <br />Temecula, CA 92592 <br />SEE PAGE 1 <br />DINTA1 <br />1 <br />Description of Operations/Locations/Vehicles: <br />GENERAL LIABILITY: <br />Additional Insured-Special Broadening Endt: 391-1006 08 16 <br />Additional Insured-Completed Operations: 391-1602 08 16 <br />Primary & Non-Contributory: 391-1003 08 16 <br />Waiver of Subrogation: 391-1003 08 16 <br />Cancellation Provision:391-1003 08 16 <br />Umbrella Cancellation Provision: CU 02 23 09 12 <br />AUTO: <br />Additional Insured: 461-0478 12 12 <br />Primary & Non-Contributory: 461-0478 12 12 <br />Waiver of Subrogation: 461-0500 11 13 <br />Auto Cancllation Provision:IL 00 17 11 98 <br />WORKERS' COMPENSATION: <br />Waiver of Subrogation: WC 00 03 13 04 84 <br />Cancellation Provision California WC 040601B <br />Cancellation Provision Arizona WC 02 06 01 C <br />Deductibles: <br />General Liability- $0 <br />Auto Liability- Comp Ded: $1,000 / Coll Ded: $1,000 <br />Umbrella: $0 <br />Professional Liability- $20,000 deductible (Per Claim). <br />DocuSign Envelope ID: 8ED90C61-FB1E-42A9-A36D-120CE7F5D38F