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�r.ac <br />Berkley Risk Adminisirators Company. LLC <br />Minnesota Workers' Compensation Assigned Risk Plan <br />Standard Workers' Compensation and Employers' Liability Policy <br />Contract Administrator <br />Berkley Risk Administrators Company, LLC <br />P.O. Box 59143 Minneapolis, Minnesota 55459-0143 <br />Phone (612) 766-3000 NCCI Carrier Code 21466 <br />MINNESOTA ENTITY AND ADDRESS SCHEDULE <br />1. The Insured: WCIP Policy Number: WC-22-04-172585-00 <br />Global Financial Outsource Services Inc Association File Number: 3157590 <br />dba: Universal Check Cashing <br />2216 West County Road D Suite C Tax ID#: F 450464425 <br />St Paul, MN 55112 UIC #: EXEMPT <br />Policy Period: From: 4/21/2006 <br />To: 4/18/2007 <br />Endorsement Eff. Date: <br />Date of Mailing: 4/20/2006 <br />Entity Information: <br />Insured Name: Global Financial Outsource Services Inc <br />Federal ID Number: F- 450464425 <br />UIC Number: EXEMPT <br />dba: Universal Check Cashing <br />2216 West County Road D Suite C <br />St Paul, MN 55112 <br />Aqencv Name and Address <br />Associated Insurance Agents Inc <br />2800 Freeway Blvd <br />Brooklyn Center, MN 55430-1751 <br />� Individual n Partnership <br />X�; Corporation '�' Other <br />WC220620 <br />1206 518940 <br />