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AGENCY CUSTOMER ID: 570000048582 <br />LOC #: <br />ADDITIONAL REMARKS SCHEDULE <br />Page _ of <br />AGENCY <br />Aon Risk services Northeast, Inc. <br />NAMED INSURED <br />Bureau veritas North America, Inc. <br />PCLICYNUMRER <br />See Certificate Number: 570055104830 <br />CARRIER <br />See Certificate Number: 570055104839 <br />NAIL CODE <br />EFFECTIVE DATE: <br />ADDITIONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: ACORD 26 FORM TITLE: Certificate of Liability Insurance <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURER <br />INSURER. <br />INSURER <br />INSURER <br />ADDITIONAL POLICIES If a policy below floes not include limit information, refer to the corresponding policy on tl)e ACORD <br />certificate form for policy limits. <br />IN56 <br />LTR <br />TYPE GP IV$DRANCB <br />ADDL <br />INSD <br />SUR <br />SEER <br />POLICY NDNrBEa <br />POLICY <br />EPFEcr <br />DATE <br />ImmmonvvY� <br />POLICY <br />LKPIRATION <br />DATE <br />(MMVDD/rYM <br />LNn15 <br />WORKERS COMPENSATION <br />B <br />N/A <br />WC013566202 <br />MA, WI <br />04/01/2014 <br />01/01/2015 <br />B <br />N/A <br />WC013566203 <br />AZ, GA, VA <br />04/01/2014 <br />01/01/2015 <br />C <br />N/A <br />WC013566204 <br />CA <br />04/01/2014 <br />01/01/2015 <br />B <br />N/A <br />WC013566205 <br />IL,KY.NC,NH,OT,VT <br />04/01/2014 <br />01/01/2015 <br />D <br />N/A <br />WC013566206 <br />FL <br />04/0112014 <br />01/01/2015 <br />e <br />N/A <br />WC015566207 <br />OR,ND,OH,WA,WY <br />04/01/2014 <br />01/01/2015 <br />ACvRD lu! (200.01) 0 2000 ACORD CORPORATION. AI) r(gMS mserved. <br />Th. ACORD name and bgo am registered Mcrks of ACORD <br />