Laserfiche WebLink
AGENCY CUSTOMER ID: CN102834971 <br /> _ LOC#: Philadelphia <br /> ACC)RE,® ADDITIONAL REMARKS SCHEDULE Page 2 of 2 <br /> AGENCY NAMED INSURED <br /> Marsh USA Inc.(Philadelphia) SNOHOMISH COUNTY CHAPTER <br /> AMERICAN NATIONAL RED CROSS <br /> POLICY NUMBER 2530 LOMBARD AVENUE <br /> EVERETT,WA 98201 <br /> CARRIER NAIC CODE <br /> EFFECTIVE DATE: <br /> ADDITIONAL REMARKS <br /> THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br /> FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance <br /> ATTACHING TO AND FORMING PART OF THE AMERICAN NATIONAL RED CROSS CERTIFICATE OF INSURANCE <br /> AS RESPECTS WORKERS COMPENSATION: <br /> This is to certify that all American National Red Cross units in the following states are currently self insured through the American National Red Cross:Alabama,California,Florida, <br /> Georgia,Massachusetts, <br /> Michigan,Missouri,Ohio,Pennsylvania,Tennessee,and Virginia. <br /> Workers Compensation Policy#MWC313809 00: <br /> Policy for all other states except the monopolistic states of North Dakota,Puerto Rico,Washington,Wyoming and U.S.Virgin Islands and the self-insured states of Alabama, <br /> California,Florida,Georgia, <br /> Massachusetts,Michigan,Missouri,Ohio,Pennsylvania,Tennessee,and Virginia.Includes Employers Liability for monopolistic states of North Dakota,Puerto Rico,Washington, <br /> Wyoming,and U.S.Virgin <br /> Islands. <br /> 'Specific Excess Workers Compensation Policy#MWFEX313804: <br /> American National Red Cross is self-insured for Workers Compensation in the state of Florida.The Excess Liability limit is subject to a state approved Self-Insured Retention. <br /> "Specific Excess Workers Compensation Policy#MWXS313805: <br /> American National Red Cross is self-insured for Workers Compensation in the following states:Alabama,California,Georgia,Massachusetts,Michigan,Missouri,Ohio, <br /> Pennsylvania,Tennessee and Virginia. <br /> The Excess Liability limits are subject to state approved Self-Insured Retentions. <br /> This certificate is issued as a matter of information only and confers no rights upon the certificate holder. <br /> ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />