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AGENCY CUSTOMER ID: <br />LOC#: <br />AC'OR[i <br />4-- ADDITIONAL REMARKS SCHEDULE Page 2 of 2 <br />AGENCY <br />SPECIALTY PROGRAM GROUP LLC/PHS <br />POLICY NUMBER <br />SEE ACORD 25 <br />CARRIER <br />SEE ACORD 25 <br />NAIC CODE <br />NAMED INSURED <br />LITTLE SAIGON TV NETWORK, INC. DBA LITTLE SAIGON TV <br />9191 BOLSA AVE STE 226 <br />WESTMINSTER CA 92683-5563 <br />EFFECTIVE DATE: SEE ACORD 25 <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM <br />FORM NUMBER: ACORD 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE <br />Coverage is primary and noncontributory per the Business Liability Coverage Form SS0008, attached to this policy. Waiver of <br />Subrogation applies in favor of the Certificate Holder per the Business Liability Coverage Form SS0008, attached to this policy <br />Certificate holder is an additional insured per the Business Liability Coverage Form SS0008, attached to this policy. <br />ACORD 101 (2014/01) © 2014 ACORD CORPOI <br />The ACORD name and logo are registered marks of ACORD <br />yr, Ride MatugonadDMsI= <br />REVIEWED&APPROVED BY: <br />® A* f, Aew44 <br />® Risk Management SpeoakM <br />