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DocuSign Envelope ID: BOCE6194-B520-4413-8CB6-FF56FO9D56AB
<br /> 2016.2016 RHI Workers Compensation Policy/Numbers
<br /> Pol_ icy# States Policy Entity Eff.Date Ex D.Date Issuing Company
<br /> RAIfPR©TNITI<
<br /> AOS:AL,AR,AZ,CO,CT, DC,
<br /> DE,GA, HI, IA,ID, IL,IN,KS, KY,
<br /> LA, MD,MI,MN, MO, NC, NE, NH,
<br /> NJ, NM,NV,NY,OK,OR,PA,RI,
<br /> 49901191 SC,TN,TX,UT,VA RHI/Protiviti 6/1/2095 6/1/2016 Ins.Co.of the State of Penn
<br /> 49901195 CA RHI/Protiviti 6/1/2015 6/1/2016 Ins,Co.of the State of Penn
<br /> 49901196 FL RHII Protiviti 6/1/2015 6/1/2016 Ins.Co,of the State of Penn
<br /> 27527602 ME RHI/Protiviti 6/1/2015 6/1/2016 Ins, Co.of the State of Penn
<br /> 49901197 MA,WI RHI/Protiviti 6/1/2015 6/1/2016 Ins. Co.of the State of Penn
<br /> .._ .._....... . .., .AOS. CO, DC,GA, IL,MD,N.
<br /> Y,
<br /> 49901202 OK,PA,TX,UT,VA Prot.Govt.Svs. 6/1/2095 6/1/2016 Ins.Co.of the State of Penn
<br /> 49901207 MA,NJ Prot,Govt.Svs. 6/1/2015 6/1/2016 Ins.Co.of the State of Penn
<br /> 49901206 CA Prot, Govt.Svs. 6/1/2015 6/1/2016 Ins.Co.of the State of Penn
<br /> 27527603 IFL Prot.Govt.Svs. 6/1/2015 6/1/2016 ins.Co. of the State of Penn I
<br /> f
<br /> f
<br /> I
<br /> I
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