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ACORD 101 (2014/01)© 2014 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />AGENCY CUSTOMER ID: <br />LOC# : <br />ADDITIONAL REMARKS SCHEDULE Page 2 of 2 <br />AGENCY <br />PLATINUM INSURANCE GROUP INC <br />NAMED INSURED <br />WESTERN AV INC <br />1521 E ORANGETHORPE AVE STE A <br />FULLERTON CA 92831-5203 <br />POLICY NUMBER <br />SEE ACORD 25 <br />CARRIER <br />SEE ACORD 25 <br />NAIC CODE <br />EFFECTIVE DATE:SEE ACORD 25 <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 />Certificate holder is an additional insured per the Business Liability Coverage Form SL3032 attached to this policy. Waiver of <br />Subrogation applies in favor of the Certificate Holder per the Business Liability Coverage Form SL0000, attached to this policy. <br />Coverage is primary and noncontributory per the Business Liability Coverage Form SL0000, attached to this policy. Notice of <br />Cancellation will be provided in accordance with Form SL9013, attached to this policy.