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Alabama Self - Insured Worker's Compensation Fund <br />Member: 649100 <br />Carr Allison Howard Oliver & Sisson PC <br />100 Vestavia Parkway <br />Birmingham, AL 35216 <br />Member FEIN: 721351859 <br />Certificate No: WC100- 0649100 -2014A <br />Certificate Period: 01/0112014 - 01/01/2015 <br />Member Unit No: 001 <br />Producer: 43104 -003 -001 <br />Insurance Office Of America /Birmingham <br />3800 Colonnade Parkway, Suite 650 <br />Birmingham, AL 35243 <br />Issue Date: 11/22/2013 <br />Effective Date: 0 1 /0 112 01 4 <br />Revision Number: <br />LOCATION SCHEDULE <br />Member Unit Name: Carr Allison Howard Oliver & Sisson PC <br />Alabama <br />Workplace: 001 - Professional Corporation <br />Carr Allison Howard Oliver & Sisson PC <br />100 Vestavia Parkway <br />Birmingham, AL 35216 <br />TAX ID: 721351859 <br />Workplace: 003 - Professional Corporation <br />Carr Allison Howard Oliver & Sisson PC <br />256 Honeysuckle Road Suite 6 <br />Brightleaf Court <br />Dothan, AL 36305 <br />TAX ID: 721351859 <br />Workplace: 005 - Professional Corporation <br />Carr Allison Howard Oliver & Sisson PC <br />400 Vestavia Parkway Suite 200 <br />Birmingham, AL 35216 <br />TAX ID: 721351659 <br />Workplace: 002 - Professional Corporation <br />Carr Allison Howard Oliver & Sisson PC <br />212 South Cedar Street <br />Florence, AL 35630 <br />TAX ID: 721351859 <br />Workplace: 004 - Professional Corporation <br />Carr Allison Howard Oliver & Sisson PC <br />6251 Monroe Street Suite 200 <br />Daphne, AL 36526 <br />TAX ID: 721351859 <br />Insumd (04111) Localion9ch ASI <br />