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Notice of Cancellation <br />AGENCY CUSTOMER ID: <br />ADDITIONAL REMARKS SCHEDULE <br />LOC #: <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 />EFFECTIVE DATE: <br />CARRIER NAIC CODE <br />POLICY NUMBER <br />NAMED INSUREDAGENCY <br />See Certificate Number: <br />See Certificate Number: <br />Aon Risk Services Central, Inc. <br /> 570000093922 <br /> 570102191854 <br /> 570102191854 <br />Page _ of _ <br />Maximus US Services, Inc. <br />With respect to the General Liability, Automobile and Workers' Compensation Policies: <br />A. If Zurich should cancel or non-renew this coverage Part (s) by written notice to the first Named <br />Insured for any reason other than nonpayment of premium, Zurich will mail or deliver a copy of such <br />written notice of cancellation or non renewal. <br />1. To the name and address corresponding to each person or organization shown in the Schedule; Certificate <br />holders as required by written contract. <br />2. At least 60 days prior to the effective date of the cancellation or non-renewal, as advised in our <br />notice to the first Named Insured. <br />3. If Zurich should cancel this Coverage Part (s) by written notice to the first Named Insured for <br />nonpayment of premium, Zurich will mail or deliver a copy of such written notice of cancellation to the <br />name and address for certificate holders where this is required by written contract, at least 10 days <br />prior to the effective date of such cancellation. <br />B. If notice as described in Paragraphs A. or B. of this endorsement is mailed, proof of mailing will be <br />sufficient proof of such notice. <br />ACORD 101 (2008/01)© 2008 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />DocuSign Envelope ID: 63E8AFC2-6818-4EB5-A9FB-757FB6CF8B11