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ACORD 101 (2008/01) <br />The ACORD name and logo are registered marks of ACORD <br />© 2008 ACORD CORPORATION. All rights reserved. <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER:FORM TITLE: <br />ADDITIONAL REMARKS <br />ADDITIONAL REMARKS SCHEDULE Page of <br />AGENCY CUSTOMER ID: <br />LOC #: <br />AGENCY <br />CARRIER NAIC CODE <br />POLICY NUMBER <br />NAMED INSURED <br />EFFECTIVE DATE: <br />BAYPLS0-01 <br />1 1 <br />Woodruff-Sawyer &Co.Bay Area PL Services dba BayPLS <br />331 Potrero Ave <br />San Francisco,CA 94103 <br />25 CERTIFICATE OF LIABILITY INSURANCE <br />Re:Forensic Blood Withdrawal Services. <br />City of Pleasanton,its officers,employees and agents are included as additional insured as respects General Liability on a Primary and Non-contributory basis <br />with a waiver of subrogation to the extent provided in the attached form. <br />Docusign Envelope ID: EAC72FF0-2F63-4ADB-9A2E-1E009CC6908F