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<br />AGENCY CUSTOMER ID: 123456
<br />LOC #: Morristown
<br />ADDITIONAL REMARKS SCHEDULE
<br />Page 2 of 3
<br />AGENCY
<br />NAMED INSURED
<br />MARSH USA, INC.
<br />Onex York Holdings Corp,
<br />and its Subsidiaries
<br />1 Upper Pond Road
<br />POLICY NUMBER
<br />Building F, 4th Floor
<br />Parsippany,NJ 07054
<br />CARRIER
<br />NAIC CODE
<br />EFFECTIVE DATE:
<br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
<br />FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance
<br />NAMED INSUREDS:
<br />ADIN HEALTHCARE, INC.
<br />ALAMED HOLDINGS, INC.
<br />ARIC OF MISSISSIPPI, INC,
<br />ARROWOOD INVESTMENT GROUP, LLC
<br />ATLANTIC GATEWAY INTERNATIONAL (SAC) LTD.
<br />ATTENTA SERVICES, LLC
<br />AXIS (EASTERN CARIBBEAN) LIMITED
<br />AXIS (JAMAICA) LIMITED
<br />AXIS DE ARGENTINA S.A.
<br />AXIS INTERNATIONAL SERVICES LTD,
<br />BICKMORE
<br />BROWN REHABILITATION MANAGEMENT, INC.
<br />CAREWORKS LTD.
<br />CAREWORKS OF OHIO LTD.
<br />CAREWORKS TECHNOLOGIES LTD.
<br />CAREWORKS USA LTD,
<br />CCI INVESTMENTS, LLC
<br />CCO, INC,
<br />CMI, A YORK RISK SERVICES COMPANY, INC.
<br />DONALD K. SAMS & ASSOCIATES, INC.
<br />F, A. RICHARD &ASSOCIATES, INC.
<br />PARA ADJUSTING SERVICES, INC,
<br />PARA BENEFIT SERVICES, INC.
<br />PARA BUSINESS SERVICES, INC.
<br />PARA GENERAL AGENCY, INC.
<br />PARA SECURITY SERVICES, INC.
<br />FOX HILL HOLDINGS, INC.
<br />FRANK GATES (BERMUDA) LTD.
<br />FRANK GATES ACCLAIM, INC.
<br />FRANK GATES ALTERNATIVE RISK, LLC
<br />FRANK GATES OF NEW YORK, INC.
<br />G2 TECHNOLOGIES, INC.
<br />INTEGRATED RISK MANAGEMENT, INC.
<br />JI SPECIAL RISKS INSURANCE AGENCY, INC.
<br />JI SPECIALTY SERVICES, INC.
<br />JOSEPH IVY FINANCIAL GROUP, INC,
<br />NATIONAL EMPLOYERS NETWORK ALLIANCE, INC.
<br />NEXUS ASSET ACQUISITION CO.
<br />OHP, INC,
<br />OMAC AGENCY, INC,
<br />ONEX YORK FINANCE LLC
<br />ONEX YORK FINANCE LP
<br />ONEX YORK MID CORP.
<br />PEPSI, LLC
<br />PUBLIC ENTITY RISK SERVICES OF ILLINOIS, LLC
<br />PUBLIC ENTITY RISK SERVICES OF OHIO, INC.
<br />ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reerved
<br />The ACORD name and logo are registered marks of ACORD ,.p�Y� Q,LGI tot
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