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DocuSign Envelope ID:54B16D7E-C063-4FF1-B6ED-4F40C221096B <br /> AGENCY CUSTOMER ID: 410000000170 <br /> LOC#: <br /> �°%°® ADDITIONAL REMARKS SCHEDULE Page _ of <br /> AGENCY NAMED INSURED <br /> Aon Risk services, Inc. of Washington, D.C. MAXIMUS Consulting Services, Inc. <br /> POLICY NUMBER <br /> see certificate Number: 570069075732 <br /> CARRIER NAIC CODE <br /> See Certificate Number: 570069075732 EFFECTIVE DATE: <br /> ADDITIONAL REMARKS <br /> THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br /> FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER <br /> INSURER <br /> INSURER <br /> INSURER <br /> ADDITIONAL POLICIES If a policy below does not include limit information,refer to the corresponding policy on the ACORD <br /> certificate form for policy limits. <br /> POLICY POLICY <br /> INSK ADDL SUBR <br /> EFFECTIVE EXPIRATION <br /> LTR TYPE OF INSURANCE INSD �V'VD POLICY NUMBER LIMITS <br /> DATE DATE <br /> (MM/DD/YYYY) (MM/DD/YYYY) <br /> WORKERS COMPENSATION <br /> D N/A wc509621602 05/01/2017 05/01/2018 Deductible $350,000 <br /> AOS <br /> ACORD 101(2008/01) ©2008 ACORD CORPORATION.All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />