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ADDITIONAL COVERAGE SCHEDULE <br />COVERAGE <br />LIMITS <br />Per Statute <br />POLICY TYPE: Workers Compensation and Employers' <br />$1,000,000 E.L. Each accident <br />Liability <br />$1,000,000 E.L. Disease—policy limit <br />CARRIER: Charter Oak Fire Insurance Company <br />$1,000,000 E.L. Disease — each employee <br />POLICY TERM: 04/0112017-04/01/2018 <br />POLICY NUMBER: HROUB-4E339258.17 <br />41tJJ �OFti� oC�e`I <br />P5y`yta <br />