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AGENCY CUSTOMER ID: <br />LOC #: <br />Pageof <br />ADDITIONAL REMARKS SCHEDULE <br />AGENCYNAMED INSURED <br />NEW TOWN INSURANCE AGENCYXanadu Service System, Inc c/o Bruce Hwang <br />POLICY NUMBER <br />CARRIERNAIC CODE <br />EFFECTIVE DATE: <br />ADDITIONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />25Certificate of Liability Insurance <br />FORM NUMBER:FORM TITLE: <br />Certificate holder is listed as an Additional insured and Waiver of Subrogation Holder. <br />ACORD 101 (2008/01)© 2008 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br /> <br />