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DocuSign Envelope ID: 2E2609DA- 01E2- 479B- 9C15- 90AAE85E5878 <br />wme Wt., <br />AGENCY <br />3referred Insurance Services, Inc <br />POLICY NUMBER <br />SEE PAGE 1 <br />CARRIER <br />SEE PAGE 1 <br />ADDITIONAL REMARKS <br />AGENCY CUSTOMER ID: FEDEENG -01 CWHOOLERY <br />LOC #: 1 <br />ADDITIONAL REMARKS SCHEDULE Page 1 of 1 <br />NAMED INSURED <br />Federal Engineering, Inc. <br />10600 Arrowhead Drive #160 <br />Fairfax, VA 22030 <br />Fairfax <br />NAIC CODE <br />SEE P 1 EFFECTIVE DATE: <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance <br />Coverages <br />Workers Compensation policy 6012243496 effective 7/1/18 - 7/1/19 for the State of CA with limits of $1 ,000,000/$1,000,000 /$1,000,000. <br />ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />