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AGENCY CUSTOMER ID: 570000027366 <br />LOC #: <br />A� ADDITIONAL REMARKS SCHEDULE <br />Page _ of _ <br />AGENCY <br />ADO Risk services Northeast, Inc. <br />NAMEDINSURED <br />Los Angeles SMSA LP <br />ROUCY NUMBER <br />See Certificate Number: 570083738856 <br />CARRIER <br />see Certificate Number: 570083738856 <br />NAIC CODE <br />EFFECTIVE DATE. <br />1 <br />ADDITIONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURER <br />INSURER <br />INSURER <br />INSURER <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 />POLICY PoLICI' <br />INSR .ADOE SITR POLICY NUMBER EFFECTIVE EXPIMTION LIMITS <br />LTR TYPE OF INSURANCE INSD M'V'D DATE DATE <br />(MM/DDAYYY) (MNI/DDNYYY) <br />AUTOMOBILE LIABILITY <br />A cA 4594301 06/30/2020 06/30/2021 <br />NH - Primary <br />A CA 4594302 06/30/2020 06/30/2021 <br />NH - Excess <br />R <br />N/A <br />WLV%J0003/9 <br />volaul LVCU <br />volavl LUL.L <br />I <br />NV <br />g <br />N/A <br />wc045886577 <br />06/30/2020 <br />06/30/2021 <br />FL <br />D <br />N/A <br />wc045886S78 <br />06/30/2020 <br />06/30/2021 <br />MA,ND,OH,WI,WY <br />B <br />N/A <br />wc045986574 <br />06/30/2020 <br />06/30/2021 <br />NI.TX,VA <br />ACORD 101 (2008101) © 2008 <br />The ACORD name and logo are registered marks of ACORD <br />REVIEWED Sr. <br />pAPPROVED B <br />Fowl Q, V&Aud <br />Bul lAmagMnenl Analyst <br />