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AGENCY CUSTOMER ID: 570000048582 <br />LOC #: <br />,4co ADDITIONAL REMARKS SCHEDULE <br />Page _ of <br />AGENCY <br />Aon Risk services Northeast, Inc. <br />NAMED INSURED <br />Bureau Veritas North America, Inc. <br />POLICY NUMBER <br />See Certificate Number: 570090931752 <br />CARRIER <br />see Certificate Number: 570090931752 <br />NAIC CODE <br />EFFECTIVE DATE: <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 />1OWN541200 <br />1OWN541200 <br />1OWN541200 <br />1OWN541200 <br />1OWN541200 <br />1OWN541200 <br />1OWN541200 <br />1OWN541200 <br />1OWN541200 <br />1OWN541200 <br />1OWN541200 <br />1OWN541200 <br />1OWBR541201 <br />1OWBR541201 <br />1OWBR541201 <br />ACORD 101 (2008/01) <br />Workers Compensation/Employers Liability <br />01101122-01101123 Trumbull Insurance AR,DC,IN,LA,NE,RI,UT <br />01101122-01101123 Twin City Fire Insurance Company FL,ND,OH,WA,WY <br />01101122-01101123 Hartford Insurance Company of the Midwest AK,ID <br />01101122-01101123 Hartford Casualty Insurance Company MO,WV <br />01101122-01101123 Nutmeg Insurance Company CT,IL <br />01101122-01101123 Hartford Fire Insurance Company NH,OR,PA <br />01101122-01101123 Hartford Accident and Indemnity Company AL,GA,KY,MI,MT,NY,TN,VT <br />01101122-01101123 Property & Casualty Ins Co of Hartford CA,CO,DE,ME, MN,MS,SC <br />01101122-01101123 Hartford Insurance Company of Illinois TX <br />01101122-01101123 Hartford Insurance Company of the southeast KS,MD <br />01101122-01101123 Hartford Underwriters Insurance Company AZ,HI,NC,N],SD,VA <br />01101122-01101123 sentinel Insurance Company, Limited IA,NM,NV,OK <br />01101122-01101123 Twin City Fire Insurance Company WI <br />01101122-01101123 Hartford Underwriters Insurance Company MA <br />01101122-01101123 Hartford Fire Insurance Company PR <br />cF RiskManaganerdDivisian <br />REVIEWED & APPRCYVED SY: <br />©2008 ACORD CORPORATION. ��'� ' 1" <br />The ACORD name and logo are registered marks of ACORD <br />--� Risk hrtanagement Analy€5t <br />