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AGENCY CUSTOMER ID: 570000027366 <br />LOC #: <br />4� a ADDITIONAL REMARKS SCHEDULE <br />AGENCY <br />Aon Risk services Northeast, Inc. <br />POLICY NUMBER <br />see certificate Number: 570083738856 <br />CARRIER <br />see certificate Number: 570083738856 <br />ADDITIONAI <br />NAMED INSURED <br />Los Angeles SMSA LP <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance <br />DATE' <br />II INSURER(S) AFFORDING COVERAGE I NAIC # <br />Page _ of _ <br />ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD <br />certificate form for policy limits. <br />INSR <br />LTA <br />TYPE OFINSURANCE <br />ADDL <br />MSD <br />SUBR <br />wVD <br />POLICYNUMBER <br />POLICY <br />EFFECTIVE <br />DATE <br />IMMIDD/1'VYl') <br />POLICY <br />EZP01LTION <br />DATE <br />(MMR)D/YYYY) <br />LIMITS <br />AUTOMOBILE LIABILIT' <br />A <br />CA 4594301 <br />NH - Primary <br />06/30/2020 <br />06/30/2021 <br />A <br />cA 4594302 <br />NH - Excess <br />06/30/2020 <br />06/30/2021 <br />WORKERS COMPENSATION <br />g <br />N/A <br />wc045886579 <br />NV <br />06/30/2020 <br />06/30/2021 <br />B <br />N/A <br />WC045886577 <br />FL <br />06/30/2020 <br />06/30/2021 <br />D <br />N/A <br />wc045886578 <br />MA,ND,OH,WI,WY <br />06/30/2020 <br />06/30/2021 <br />R <br />N/A <br />wc045886574 <br />N],T ,VA <br />06/30/2020 <br />06/30/2021 <br />ACORD 101 (2008/01) a zuun <br />The ACORD name and logo are registered marks of ACORD <br />Risk Mar ag..d Division <br />< REmEwED fi APPROVED fir. <br />s� It Few a vjti� <br />Comm <br />�...�' NPI,Management Analyst <br />