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AGENCY CUSTOMER ID: CN1O19767O2 <br />LOC* Washington <br />ADDITIONAL REMARKS SCHEDULE Page 2 of 2 <br />AGENCY <br />NAMED INSURED <br />MARSH USA INC. <br />IONIA RETREMENTCORP. <br />ATIN 0'J UANA THOMAS <br />777 NORTH CAPITOL ST., NE <br />POLICY NUMBER <br />WASHINGTON, OC 20002 <br />CARRIER <br />NAIC CODE <br />EFFECSNE DATE: <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance <br />FIDELITY BONOIGRI ME'. <br />CARRIER GTealAmerican Insurance Company <br />POLICY NO FS2346364 <br />EFPEXP. O93120M 0613O219 <br />LIMIT $25OATOOO <br />LEO.$2@,000 <br />ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks ofACORD <br />