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AGENCY CUSTOMER ID: MEKOPRI-01 <br />LOC #: 1 <br />AANAYA <br />ACOR©" <br />ADDITIONAL REMARKS SCHEDULE <br />AGENCY NAMED INSURED <br />PIASC Insurance Services, Inc. Mekongg Printing, Inc. <br />Hoan Tru <br />POLICY NUMBER 2421 W. Firons} Street <br />EE PAGE 1 Santa Ana, CA 92703 <br />CARRIER NAIC CODE <br />EE 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 />APPLICABLE HANOVER COVERAGE FORMS <br />APPLICABLE HANOVER COVERAGE FORMS: <br />COMMERCIAL GENERAL LIABILITY BROADENING ENDORSEMENT 421-2915 06/15: <br />ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT <br />ADDITIONAL INSURED - PRIMARY & NON-CONTRIBUTORY <br />BLANKET WAIVER OF SUBROGATION <br />COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT 421-2916 06/15: <br />ADDITIONAL INSURED - BROAD FORM VENDORS <br />Page 1 of 1 <br />HANOVER PRIMARY & NON CONTRIBUTORY COVERAGE FORM CG 20 01 04 13 <br />HANOVER - ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS CG 20 37 04 13 <br />HANOVER PRIMARY AND NON CONTRIBUTORY - OTHER INSURANCE CONDITION CG 20 01 04 13 <br />COMMERCIAL AUTO - BUSINESS AUTO COVERAGE BROADENING ENDORSEMENT 461-0155 (9/97) <br />BLANKET WAIVER OF SUBROGATION <br />oR.N a Risk ManagmumtDMslcrn <br />f ° REVIEWED & APPROVED BY: <br />1" Risk Management Specialist <br />ACORD 101 (2008/01) © 2008 ACORD <br />The ACORD name and logo are registered marks of ACORD <br />