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AGENCY CUSTOMER ID: <br />LOC #: <br />ACCO ® <br />ADDITIONAL REMARKS SCHEDULE Page of <br />AGENCY <br />NAMED INSURED <br />JLT Specialty USA <br />Kapsch TrafflcCom Holding II US Corp. <br />8201 Greensboro Drive <br />Suite 1002 <br />POLICY NUMBER <br />McLean VA 22102 <br />PCS003157 17 <br />CARRIER <br />NAIC CODE <br />AXA Insurance Company <br />33022 <br />EFFECTIVE DATE:11/30/2017 <br />- - ----• - I v ZuV0 At UKU UUKPUHA T ION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD ATTACHMENT <br />39659054 1 17-10 - GL AD UMD WC I Darya Xavalenka 1 12/29/2017 11:56:22 AM (PST) I Page 2 of 2 <br />REVIEWED BY: EUNICE HEREDIA (PGOF <br />