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DocuSign Envelope ID: 3F0F44D1-0249-418D-A8C6-A7EDC761 CC87 <br /> AGENCY CUSTOMER ID: ENTER <br /> LOC#: St.Louis <br /> AC ADDITIONAL REMARKS SCHEDULE Page 2 of 2 <br /> AGENCY NAMED INSURED <br /> Marsh USA Inc. Enterprise Fleet Management,Inc. <br /> 600 Corporate Park Drive <br /> POLICY NUMBER Si Louis,MO 63105 <br /> CARRIER NAIC CODE <br /> EFFECTIVE DATE: <br /> ADDITIONAL REMARKS <br /> THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br /> FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance <br /> Workers Compensation coverage for employees in Puerto Rico and in the States of North Dakota,Washington,and Wyoming is provided through the Monopolistic State programs. <br /> Workers Compensation coverage for employees in Ohio is self-insured.Workers Compensation policy#HC2J-UB-474M7050-16 provides Employers Liability for all States with the <br /> exception of Wisconsin.Policy#HRJ-UB-474M7062-16 provides Employers Liability for Wisconsin. <br /> ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />