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AGENCY CUSTOMER ID: <br />LOC #: <br />A OR ADDITIONAL REMARKS SCHEDULE <br />Page 2 of 3 <br />AGENCY <br />NAMED INSURED: SPECIAL LIABILITY INSURANCE PROGRAM (SLIP) MEMBER: <br />ALLIANT INSURANCE SERVICES, INC. <br />ANAHEIM TRANSPORTATION NETWORK DBA ANAHEIM RESORT <br />TRANSIT; ATN ASSET HOLDING COMPANY, LLC <br />POLICY NUMBER <br />PAC 1000082 05 <br />1354 S. ANAHEIM BLVD, <br />ANAHEIM, CA 92805 <br />CARRIER NAC CODE <br />ASSOCIATED INDUSTRIES INSURANCE CO. ; 23140 <br />EFFECTfVEDATE: 09/29/16 <br />ADDITIONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM 18 A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: ACORD 25 (2009109) FORM TITLES CERTIFICATE OF LIABILITY INSURANCE <br />Notice of cancellation will be delivered only to the participating named insured as stated in Item 1 of the Participation <br />Endorsement. <br />The Company may cancel the coverage by mailing to the first Participating Named Insured at the address shown in the participation <br />endorsement written notice stating when, not less than sixty (60) days thereafter, such cancellation shall be effective. Provided that the <br />Participating Named Insured fails to discharge, when due, any of its obligations in connection with the payment of premium for the policy or <br />any installment thereof, the coverage may be canceled by the Company by mailing to the Participating Named Insured at the address <br />shown in the participation endorsement, written notice stating when, not less than ten (10) days thereafter, such cancellation shall be <br />effective. <br />�3 <br />I ne A-- name ena logo are reglsiere4 ma1Ks or Awmu <br />