GOVERNMENT STAFFING SERVICES, INC. (DBA MUNITEMPS MUNICIPAL STAFFING SOLUTIONS)-2014

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Policy Number PRA 9699063-02 SCHEDULE OF FORMS AND ENDORSEMENTS Named Insured: Government Stalling Service, Inc. EiTective Date: 05/10/2014 12:01 A.M., Standard Time Agent Name: World Wide New York Insurance Services, Inc. Agent No, 782930M COMMON POLICY FORMS AND ENDORSEMENTS U -GU -727-A CW 0806 Cover Sheet L -OU -630-C 1207 Terrorism Disclosure - Policy Endorsement U -SI -0-100-A CW 1011 Common Policy Declarations U -GU -319-F 0109 Important Notice - In Witness Clause U -GU -619•A CW 1002 Schedule of Forms and Endorsements U -GU -621•A CW 1002 Schedule of Named Insured(&) IL 0003 0908 Calculation of Premium IL 00171198 Common Policy Conditions IL 0021 0906 Nuclear Energy Liability Exclusion Endorsement IL 0270 0908 Califarrrla Changes - Cancellation And Nonrenewal U -GU -298-B 0494 Cancellation By Us U -81-104-A CA 1011 California Changes 1.1SI-105-A CA 1011 Cailf0mia Changes - Cancellation And Notuenewai U -GU -767-A CW 0108 Cap On Lasses From Cerfifted Acts Of Terrorism GENERAL LIABILITY FORMS AND ENDORSEMENTS U -SIL -0-100-A CW 1011 Commercial General Liability Declarations CG 0001 1207 Commercial Liability Coverage Form 00 21471207 Employment Related Practicas Exclusion CG 3234 0105 California Changes U-01.423-8 CW 0604 Silica Cr Silica Mixed Dust Exclusion U -GL -t 171-A CW 0703 Fungi Or Bacteria Exclusion Endorsement U•GL-1178-ACW 0703 Asbestos Exclusion Endorsement U-GL4250-A CW 0905 Abuse Or Molestation Exclusion U•GL-1327-A CW 0307 Other Insurance Amandmant - Primary And Non -Contributory U -GL -1342-A CW 1007 Lead Liability Exclusion U -GL -1617-A CW 0112 Collection or Distribution of Material or Information In Violation of Law Exclusion USIL-102-A CW 1011 Designated Project Limits Of Insurance Endorsement U -SIL -106-A CW 1011 Staffing Industry Amendatory Endorsement EMPLOYEE BENEFITS LIABILITY FORMS AND ENDORSEMENTS U -GL -D -851-S CW 0904 EK - Occurrence Declarations U -GL -851-8 CW 0604 EBL - Occurrence Coverage Form U -SIL -108-A CW 1011 Employee Benefits Liability Amendatory Endorsement EMPLOYMENT PRACTICES LIABILITY FORMS AND ENDORSEMENTS U -SIL -D -101-A CW 1011 Staffing Industry Employment Practices Liability Declarations (Claima-Made) USI012-A CW 1011 Staffing Industry Employment Practices Uabillty Coverage Form (Claims -Made) STOP GAP FORMS AND ENDORSEMENTS U -GL -274-0 MU 0506 Stop Gap Employers Liability Declarations U -GL -274-C-1 CW 1204 Stop Gap Employers Liability Coverage Form U-GU4t9-A CW (I6l02)