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ACORD 101 (2008/01) <br />The ACORD name and logo are registered marks of ACORD <br />© 2008 ACORD CORPORATION. All rights reserved. <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: FORM TITLE: <br />ADDITIONAL REMARKS <br />ADDITIONAL REMARKS SCHEDULE Page of <br />AGENCY CUSTOMER ID: <br />LOC #: <br />AGENCY <br />CARRIER NAIC CODE <br />POLICY NUMBER <br />NAMED INSURED <br />EFFECTIVE DATE: <br />Willis North America, Inc. <br />and its subsidiaries <br />200 Liberty Street <br />New York, NY 10281 <br />INSURER AFFORDING COVERAGE: Willis Submission Carrier NAIC#: GENRC <br />POLICY NUMBER: SM1920 EFF DATE: 07/01/2019 EXP DATE: 07/01/2020 <br />TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: <br />Errors & Omissions Per Claim $5,000,000 <br /> Aggregate Limit $5,000,000 <br />ADDITIONAL REMARKS: <br />Professional Indemnity Insurance (Errors & Omission Liability) Carrier: Stone Mountain Insurance Company. <br />All employees of Willis North America and its subsidiaries are included as Insureds under the Errors & Omissions <br />policy. <br />INSURER AFFORDING COVERAGE: Sentry Insurance a Mutual Company NAIC#: 24988 <br />POLICY NUMBER: 90-20597-02 EFF DATE: 07/01/2019 EXP DATE: 07/01/2020 <br />TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: <br />Workers Compensation & EL Each Accident $1,000,000 <br />Employers Liability EL Disease - Each Emp $1,000,000 <br />Per Statute EL Disease-Policy Lmt $1,000,000 <br />22 <br />Willis of New York, Inc. <br />See Page 1 <br />See Page 1 See Page 1 See Page 1 <br />25 Certificate of Liability Insurance <br />W11732990CERT:1256550BATCH:18150101SR ID: