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AGENCY CUSTOMER ID : 17215 <br /> LOC #: <br /> ACS ADDITIONAL REMARKS SCHEDULE Page of <br /> AGENCY NAMED INSURED <br /> Venbrook Insurance Services CA Lic OD80832 RADC Enterprises, Inc. <br /> 1450 N Benson Ave. , Suite A <br /> POLICY NUMBER Upland CA 91786 <br /> STL0001434 <br /> CARRIER NAIC CODE <br /> Mt Hawley Insurance Company 37974 EFFECTIVE DATE: 6/30/2020 <br /> ADDITIONAL REMARKS <br /> THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br /> FORM NUMBER: 25 FORM TITLE : Certificate of Liability (03116) <br /> HOLDER: Anabi Real Estate Development, LLC. <br /> ADDRESS : 1450 N Benson Ave Suite A Upland CA 91786 <br /> AISLE # 1 - Stores - UST Tank Locations <br /> 43 Lincoln Blvd Lincoln CA 95648 Aisle 1 Store # 280 <br /> 10430 Twin Cities Road Galt CA 95632 Aisle 1 Store # 352 <br /> 4219 East Morada Lane Stockton CA 95212 Aisle 1 Store # 356 <br /> 1020 Emerald Bay Rd South Lake Tahoe CA 96150 Aisle 1 Store # 177 <br /> 3020 Floyd Ave . , Suite 189 Modesto CA 95355 Aisle 1 Store # 389 <br /> 25045 Blue Ravine Rd . , Folsom CA 95630 Aisle 1 Store # 450 <br /> 5345 Hazel Avenue Fair Oaks CA 95628 Aisle 1 Store # 481 <br /> 1813 E Gibson Rd . Woodland CA 95776 Aisle 1 Store # 576 <br /> 3250 Arena Blvd . Sacramento CA 95834 Aisle 1 Store # 578 <br /> 2325 Sunset Blvd . Rocklin CA 95765 Aisle 1 Store # 588 <br /> 2681 Blanding Ave Alameda CA 94501 Aisle 1 Store # 682 <br /> 1690 Robb Dr Reno NV 89436 Aisle 1 Store # 155 <br /> 2433 Wingfield Hills Road Sparks NV 89436 Aisle 1 Store # 160 <br /> i <br /> i <br /> ACORD 101 (2008101 ) © 2008 ACORD CORPORATION . All rights reserved . <br /> The ACORD name and logo are registered marks of ACORD ADDENDUM <br /> 56438314 1 17215 1 2020 UST E Premises Site Pollution Cert Michele Baierl 17 / 6 /2020 1 : 31 : 06 PM ( PDT) Page 2 of 2 <br /> This certificate cancels and supersedes ALL previously issued certificates . <br />'i+ <br />