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DocuSign Envelope ID:2D4F9426-4542-4C8B-8119-E035F9A99D35 AGENCY CUSTOMER ID: 570000032784 <br /> LOC#: <br /> '4 ADDITIONAL REMARKS SCHEDULE <br /> Page _ of _ <br /> AGENCY NAMEDINSURED <br /> Aon Risk Services Central, Inc. Res-Care, Inc. <br /> POLICY NUMBER <br /> See Certificate Number: 570082857957 <br /> CARRIER NAIL CODE <br /> See Certificate Number: 570082857957 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 /> Additional coverages <br /> workers' compensation Policies - 7/1/2020-7/1/2021 <br /> WLRC67454583 (All other States) - Indemnity Insurance Co. of North America, NAIL #43575; <br /> WLRC67454546 (CA/MA) - ACE American Insurance Co. , NAIC #22667; <br /> SCFC67454625 (WI) - ACE Fire Underwriters Insurance Co., NAIC #20702; <br /> Cov. A - Statutory <br /> Cov. B - $2,000,000 Each Accident / $2,000,000 Each Employee (Disease) / $2,000,000 Agg. (Disease) <br /> Ohio/Washington Excess workers' Compensation <br /> Pol # wcuc67454662 - ACE American Insurance Co., NAIC #22667; <br /> Cov. A - Statutory <br /> Cov. B - $2,000,000 Each Accident / $2,000,000 Each Employee (Disease) / $2,000,000 Annual Aggregate <br /> Retention: $1,100,000 <br /> ACORD 101(2008/01) ®2008 ACORD CORPORATION.All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />