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AGENCY CUSTOMER ID:GRAFPRO-01 MSHIVAKUM <br /> LOC#: 1 <br /> A EP" ADDITIONAL REMARKS SCHEDULE Page 1 of 1 <br /> AGENCY License#0757776 NAMED INSURED <br /> HUB International Insurance Services Inc. Graffiti Protective Coatings,Inc. <br /> 4624 E.Florence Ave <br /> POLICYNUMBER Bell,CA 90201-4386 <br /> SEE PAGE 1 Los Angeles <br /> CARRIER NA1C CODE <br /> SEE PAGE 1 SEE P 1 EFFECTIVE DATE:SEE PAGE 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 /> Description of Operations/Locations/Vehicles: <br /> Liability policy,when required by written contract,per the attached endorsement form EPACE113 07114.Additional Insured with <br /> regard to the Auto Liability policy,when required by written contract,per the attached endorsement form GAT353 02115,Waiver of <br /> Subrogation included.Waiver of Subrogation applies to the Workers Compensation policy,when required by written contract,per <br /> the attached endorsement form WC990376A 001. <br /> 30 Days Notice of Cancellation with regard to General liability per the attached endorsement form EPACE106 07114. <br /> ACORD 101 (2008/01) ©20D8 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />