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M� � ti `J oi�� po a ° ° A p�p�' � � � � �N � � � p ~ � ` � � _ _ _ __ U _ _�� p � c`� _� , � a a � � � � � z � � � z �p � � � � � Z a V www.capecodsafetytraining.com ' ' NSC CPR Course .'' . � � Infant, Child, Adult, FBAO & AED 3 hour class OSHA CPR 1910.151 Name: Carole Harrison security contro�No. Add�s�: , 18 5 2 7 3 Address: 1314 Route 28 City, State,Zip: S,y�outh,Ma 02664 Course Completion Date: 1p�2g/2016 Training Center: ��y Training Expiration Date: 10l2812018 Instructor Name: Rick Todd Instructor Number: 1040918 . ' Carole Harrison has successfully completed the NSC CPR Course based on the current Guidelines for CPR and ECC. The National Safety Council saves lives by preventing injuries and deaths at work, in homes and communities i ' and on the roads through leadership,research,education and advocacy. i For more lite-saving courses from NSC please visit nsc.org/fatraining � - THIS DOCUMENT IS VOID IF REPRODUCED _ - _ _ _ _ . _ _ � _ _ _ _ Security Control No. �� Caroie Harrison 1�5 2 7 3 ' - ♦ � has completed the NSC CPR Course Your experience in the National Safety Council CPR,Adu�,Child,IMaM 8 AED couse you took is very important to us. rrain�nq center. Cape Cod Safietyr Traini� Please give us your feedback at comPiet�on�ate: �a��s . nsc.org/firstaidevaluation Expires: ��8 Instructional Hours 3 hr'. � �'y� #10da.91R Instructor Signature Instructor No. N.S�i-in it for life� nsc.org/fatraining . . . . . . . . -. .. •. 300M0316 1015 900008130�2016 National Safety Council 79174-0000 www.capecodsafe ainin .� com • � NSC First Aid Course - � . , . � Includes: Epipen 2 hour class OSHA First Aid 1910.151 Name: Carole Harrison s��rity Control No. Address: • Address: 1314 Route 28 5 9 4 7 41 City,State,Zip: South Yarmouth,Ma 02664 Course Completion Date: �0/28/2016 Training Center: �Pe��Y Training Expiration Date: 10/2812018 Instructor Name: �ck Todd Instructor Number: ��$ � . Carole Harrison has successfully completed the NSC First Aid Course. . The National Safety Council saves lives by preventing injuries and deaths at work, in homes and communities and on the roads through leadership,research,education and advocacy. For more I'rfe-saving courses from NSC please visit nsc.org/fatraining ` THIS DOCUMENT IS VOID IF REPRODUCED __. .__ Security Control No. � Carole Harrison 5(.�4 '7 41 � has compieted the ' ' NSC First Aid Course Your experience in the National Safety Council ' couse you took is very important to us. , Train�n9 center: Ca�e Cod Safety Training ' Please give us your feedback at compiet�on�ate: 1012812016 nSC.org/firstaldevaluatlOn ' Expires: 10128/2018 Instructional Hours: 2 �� y� #1040918 Instructor Signature Instructor No. NSC-in it for life� nsc.org/fatraining '� • • � � � • • • -� •� -• 350M0316 1015 900008129�2016 Nationat Safety Counal 79173-0000 www.capecodsafetytraining.com � NSC CPR Course � ; ; - � " � � � � infant, Child, Adult, FBAO & AED 3 hour class OSHA CPR 1910.151 Name: PIj/USh P�el security Control No. Add�sS: . 15 5 0 5 2 Address: 573 Main Street,Route 28 1314 Main Street,Rt 28 City, State,Zip: W,y�outh,Ma 02673 S.Yannouth,MA 02673 Course Completion �f2016 Training Center: Cape Cod Safety Training Expiration �t1�12018 Instructor Name: Rick Todd Instructor Number: 1040918 . Pi_vush Patel has successfully completed the NSC CPR Course based on the current Guidelines for CPR and ECC. , The National Safety Council saves lives by preventing injuries and deaths at work, in homes and communities and on the roads through leadership, research,education and advocacy. For more life-saving courses from NSC please visit nsc.org/fatraining � THIS DOCUMENT IS VOID IF REPRODUCED _ -- -_ _.. --_. _... _ - __ _ __ Security Control No. ; � Piyush Patel 15 5 0 5 2 � ' has completed the ' ' NSC CPR Course Your experience in the National Safety Council CPR,Adu�,Chiid,MfaM 8 AED couse you took is very important to us. ' rrainin9 center: Cape Cod Safetyr Traming Please give us your feedback at ' comPietion�ate: 1111712016 1tSC.orgffirstaidevaluation �ires: �iMl��$ Instructional Hours: 3 hr !v o/1^ #1040918 Instruc or Signature Instructor No. N.7C-in it for life� nsc.org/fatraining • • • � � • • -• •• -. 300M0316 1015 900008130�2016 National Safery Council 79174-0000 www.ca�ecodsafe trainin .com NSC First Aid Course � , . � Inciudes: Epipen 2 hour class OSHA First Aid 1910.151 Name: PiyuSh PBte� Security Control No. Address: Address: 573 Main Street,Rt28 1314 Main Street,Route 28 615 014 City, State,Zip: W,y�outh,MA 02673 South Yarmouth,MA 02664 Course Completion Date: 11/1712016 Training Center: ��Training Expiration Date: 1111712018 Instructor Name: Rick Todd Instructor Number: 1040918 . Piyush Patel has successfully completed the NSC First Aid Course. The National Safety Council saves lives by preventing injuries and deaths at work, in homes and communities � " and on the roads through leadership, research,education and advocacy. For more life-saving courses from NSC please visit nsc.org/fatraining . THIS DOCUMENT IS VOID IF REPRODUCED _ _ . -_ ______ _ ___ ..._ _ _ __ _ _ � Security Control No. ' + Piyush Patei �j � '�'�' Q 1� + � has completed the NSC First Aid Course Your experience in the National Safety Council ' couse you took is very important to us. Trainin9 cencer. Cape Cod Safety Training Please give us your feedback at compietion�ate: �1/1712016 nsc.org/firstaidevaluation Exp�res �1//1�7@018 Instructional Hours: 2 ��iGfi��` /��ri�y #1040978 Instructor Signature Instructor Na N.S�i-in it for life' nsc.org/fatraining -• • . . ,, _ 350M0316 1015 900008129 �2016 National Safety Council 79173-0000 www.capecodsafetytrainin .� com • � NSC First Aid Course _ "F � . . . ; � Includes: Epipen 2 hour class OSHA First Aid 1910.151 Name: DaVld Dut118S sec�rity Contro�No. � Address: , C '� 5 0�3 � U Address: 237 N.Main Street Apt 216 � Ciry, State,Zip: South Yarmouth,MA 02664 � Course Completion Date: 10/2812016 Training Center: ��,y Training Expiration Date: 10►2812018 Instructor Name: �k Todd Instructor Number: 1040918 ' . David Dumas has successfully completed the NSC First Aid Course. ; The National Safety Council saves lives by preventing injuries and deaths at work, in homes and communities ; � and on the roads through leadership,research,education and advocacy. For more life-saving courses from NSC please visit nsc.org/fatraining • i i THIS DOCUMENT IS VOID IF REPRODUCED I , _ ___ _ _ _ _ � _ __ _ I ,__ Security Control No. , � David Dumas �j,Z � � `�3 � ', has compieted the ' ' NSC First Aid Course Your experience in the National Safety Council couse you took is very important to us. Train�n9 center: Cape Cod Safety Traini� Please give us your feedback at ' comPietion�ate: 10Y1812016 nsc.org/firstaidevaluation ��res: �0128/2018 Instructional Hours: 2 �e��4�f #1040918 : Instructor Signature Instructor No. NSCi-in it for life' nsc.org/fatraining -• • • � -� •� 350M0316 1015 900008129�2016 National Safety Council 79173-0000 www.capecodsafetytraining.com NSC CPR Course � " � � � lnfant, Child, Adult, FBAO & AED 3 hour ciass OSHA CPR 1910.151 Name: DBVId DUt118S Security Control No. AddresS: . 16 9 0 9 4 Address: 237 N.Main Street#216 Ciry, State,Zip: South Yarmouth,Ma 02664 Course Completion Date: 10128/2016 Training Center: Cape Cod Safety Training Expiration Date: 10I2812018 Instructor Name: Rick Todd Instructor Number: 1040918 J David Dumas has successfuily completed the NSC CPR Course based on the current Guidelines for CPR and ECC. ; The National Safety Council saves lives by preventing injuries and deaths at work,in homes and communities j � and on the roads through leadership, research,education and advocacy. For more fife-saving courses from NSC please visit nsc.org/fatraining � THIS DOCUMENT IS VOID IF REPRODUCED ____ Security Controi No. � '1'. David Dumas �6 9 0 9 4 . � � has completed the NSC CPR Course Your experience in the National Safety Council CPR,Adu�,Chi1d,1��8 AEp couse you took is very important to us. Trainin9 center: Cape Cod Safety Training Please give us your feedback at compiet�on�ate: �p�g�p�g nsc.org/firstaidevaluation Expires: ��$ Instructional Hours: 3 hr ��'�� #1040918 ' Instructor Signature Instructor No. N.SCi-in it for fife� nsc.orgffatraining -. . . . . . . . . •. .. -. 300M0316 1015 900008130�2016 National Safety Council 79174-0000 , www.capecodsafetytraining.com ' � � NSC CPR Course ' � � ' � � � lnfant, Child, Adult, FBAO & AED 3 hour ciass OSHA CPR 1910.151 rvame: Pinal Patel s�U��,,c�„t�o,No. Add►�SS: . 16 9 0 9 9 Address: 1314 Rt 28 City,State,Zip: South Yarmouth,Ma 02664 Course Compietion Date: 10128/2016 Training Center: Cape Cod Safety Training Expiration Date: ��018 Instructor Name: Rick Todd Instructor Number: ��18 � . Pinal Patel has successfully completed the NSC CPR Course based on the current Guidelines for CPR and ECC. , The Natic?nal Safety Council saves lives by preventing injuries and deaths at work,in homes and communities � and on the roads through leadership,research,education and advocacy. For more I'rfe-saving courses from NSC please visit nsc.org/fatraining - THIS DOCUMENT IS VOID IF REPRODUCED � __.. __ Security Control No. � Pina1 Pate1 16 9�g 9 ' �� '� has completed the ' NSC CPR Course Your experience in the National Safety Council - . CPR,Aduk,Child,IMar�&AED couse you took is very important to us. rrainin9 center: Cape Cod Safety Training . Please give us your feedback at compie�ion oate: 10f2812016 nsc.orgffirstaidevaluation Expires: ��$ instructional Hours: 3 hr: '��7P t�/ #1040918 ' Instructor Signature Instructor No. NSCi-in it for life' nsc.org/fatraining . . . . . . . . .. .. .. soo�na3i s i oi s s0000ei so�2oi s rvat�ona�sarery counc�i �si�a-0000 www.capecodsafe ainin .� com NSC First Aid Course - � . � � � Includes: Epipen 2 hour class OSHA First Aid 1910.151 Name: pinal Patel s�urity Control No. Address: . C � c o�� Address: 1314,Route 28 0 J � City, State,Zip: South Yarmouth,MA 02664 Course Completion Date: 10/2812016 Training Center: Cape Cod Safety Training Expiration Date: 10/28/2018 Instructor Name: RickTodd Instructor Number: 1040918 . Pinal Patel has successfully completed the NSC First Aid Course. The National Safety Council saves lives by preventing injuries and deaths at work,in homes and communities and on the roads through leadership,research,education and advocacy. For more life-saving courses from NSC please visit nsc.org/fatraining - THIS DOCUMENT IS VOID IF REPRODUCED _ _ _._ _._ . _ __ ... - -.- _ _ : _ � Security Control No. ' + Pinai Patel 615 Q:�7 � has completed the ' NSC Pirst Aid Course Your experience in the National Safety Council couse you took is very important to us. Tra�n�n9 center: Please give us your feedback at ', compietion oate: Cape Cod Ssfety Training 10/28f2016 nsc.org/firstaidevaluation E"P'r�� 10128/2018 �nstructional Hours: Z ; �oiYl #1W0918 Instructor Signature Instructor No. NVV-in it for life" nsc.org/fatraining -• • • � • • � • • •• •• •� 350M0316 7Ot 5 900008129�2016 National Safely Council 79173-0000 www.capecodsafetytraining.com NSC First Aid Course � , . � � . . 3 hour class OSHA 1910.151(b) Name: Tina Patel securiry Control No. Address: C � C O�� Address: � `� 1314 Main Street,Route 28 City, state,Zip: South Yarmouth,MA 02664 Course Completion Date:� Training Center: . Expiration Date: 11H7I16 Instructor Name: Cape Cod Safety Training �11117178 Instructor Number: �Todd � - 1040918 �i��. ��tp� has successfully completed the NSC First Aid Course. The National Safety Council saves lives by preventing injuries and deaths at work, in homes and communities ` and on the roads through leadership,research,education and advocacy. For more I'rfe-saving courses from NSC please visit nsc.org/fatraining - THIS DOCUMENT IS VOID IF REPRODUCED _ _ _ _ _ _ - - -- _.._... __ -___ __ - - - _ ___ ____ � Security Control No. 'F 6:i50�.1 . .�♦, Tina Patel � has completed the NSC First Aid Course Your experience in the National Safety Council ', couse you took is very important to us. Tra�n�n9 center: Cape Cod Safety Training Please give us your feedback at ' compietion�ate: I1SC.0�/fl�IdeV81U8t1011 Fxpires: 11177I76 Instructional Hours: , 11M7178 3 hr ' ' !�.��yv ', Instructor Signature u No. NSC-in it for life� nsc.arg/fatraining -• • • • • . . . . -. .. -. 350M0316 1015 900008129�2016 National Safely Council 79173-0000 ' Technolo� Insurance Company ; A�LL3Gk 1t'!ailt'BCfC��4R1(3�11)t ': t�U[1RKEFiS C�MPENSATif?N . WG 99 Ot3 C�1 8 ANl�EMPLOYERS LlABIIITY INSt1RAF�tGE POLtCY IP+IF4RMA7'ION F'AGE - �. .��.._ _.�.,.H� �..,�.�.�:_�. :�G��e�az: ��a�� , t. Insure�i' l'"c�licv�tumber: T��'C3532$21 ; G��tri�vp�Corp. _ . � DBr�: x�,tiiba�sadorTnn&Suites 131�R�aut�28 _ Fndividual Pactnership Sauth Yannouth,i�1�1 Q2fi6� X Cor�oration i Other warkplac��not sh�wn�bove: -- See Extensi�n€�f infc�rmatisan F'age Federal.T`a,�c IU: 2C`�055((�56 Pr.aelueer: Risk id: :1mTrust l�i7tth America>izi�e. . . Rene�v<�I o1': Tt�('3�615�K cJo GH I)��nn I��surance�gcnc}�,Ii�e. F.U:Bc�x�97 _: _ __ �f�t�apaisett>M�b2734 2. The pcilicy periaii is from 3f9/ZUl;6 u�3/�}T201"� 12:01 a.m.at th�insured's rnailin�address. .3. 4, Workers Ccimpe�sation Insurance:Fart One af the,policy agpties ta the Wc�ckers�ampensation Law�of zhe stat�s listed hece:Massaehusetts B. Employ'ers I.iabitit}�Ii�curance:Patt Two�#�the policy appiies to w«rk in each sEa7c listed in iien3.;3„�, The lir�it5�f our iial�lit�under�Tw•o are: 5tiate �3vr�ily Inaury bi��ccident Botiiiy Injury:by�'rseas� B�d`tiy Inj�ary by L}i5ease �5Qf1,t�fl0 each accident �504,�30�olicy limit s5(X},tlfX)each enz��la�c;e C: 4the�-5tates insurance:Par�Tttre�of tl7e palic}'applies tc�the states.if any,iist�c�here: All statx;s except ND,C�H,WA,Wl'a�d State(s)Dc:si�nated in[tern 3A. D. This p�tic}=iz�cludes these enc#arsem�n�.�and schedute�:S�e�xtensior�of Infarmation,Page 4, The premi.um for this�Qii��rili b�cielcrmineti by our iVlanuaEs cif Rudes.Glassific�tions:Rates anci R�tin� Pians.all int`ormatic�n required b�low is siubje�t to uerific�ti�n aitd eharige bv aueiit: See Extentiian Qf Fnfarmaticin i'�.ge TOT�L ESTIVIATEII A1��AL;PRE��IU?�i ��: ; ST�TE A�SES�MENT �� TQTAL ES'TIM.ATEI}�(.?ST � ��, I�Tinimum P�ernium �' �12 Bepc�sii Frernium � < � 1.�i3�# Issue Datc;: 1i27t?01(i Cauntersigned�y: , _ ,�u 'xed Represent�titi•e: ; _ - , , � � _ �.N . . .. - . � . .. � ��. .. . . . . .�. . � . � . . . , . � ... . . . . . .. . . �.� .. . . . . . . �N . . . . � . . . � � 53 � .� . . �� . www.capecodsafetvtrainin .� com . . i ' F�r t A� rse N C s d Cou '� S , , . � Includes: Epipen 2 hour class OSHA First Aid 1910.151 I rvame: p�nal Patel s��riry Control No. I Address: . 6� 5�1� j Address: 1314,Route 28 j City, State,Zip: South Yarmouth,MA 02664 � Course Completion Date: 1012812016 Training Center: �p��y Training Expiration Date: 10I28/2018 Instructor Name: Itick Todd Instructor Number: 1040918 . Pinal Patel has successfully completed the NSC First Aid Course. The National Safety Council saves lives by preventing injuries and deaths at work,in homes and communities � � and on the roads through leadership,research,education and advocacy. i For more life-saving courses from NSC please visit nsc.org/fatraining - THIS DOCUMENT IS VOID IF REPRODUCED _ _ _ ___ ____ ---- - - -- - _ _ _ _ � Security Controi No. ♦ Pinal Patel 6�.5 0 :�7 � ', has completed the • Nsc F�rst aa co��e Your experience in the National Safety Council couse you took is very important to us. Tra�n�n9 center. Cape Cod Safet�r Tra�ing Please give us your feedback at ', compiet�on�ate: 10/28/2016 nsc.org/firstaidevaluation I �"�� 1012812018 �nstructional Hours: 2 �.%OiY/ #1040918 Instructor Signature Instructor No. N�7C-in it for life� nsc.org/fatraining '' • • ' • • ' • • • •• '� 350M0316 1015 900008129�2016 National Safety Council 79173-0000 www.capecodsafetytraining.com • � NSC CPR Course - '�" ' � � � Infant, Child, Adult, FBAO & AED � 3 hour ctass 4SHA CPR 1910.151 Name: PI1181 P8t21 Security Contro�No. Address: . 16 9 0 9 9 Address: 1314 Rt 28 City,State,Zip: South Yarmouth,Ma 02664 Course Completion Date: 1012812016 Training Center: Cepe Cod SafetY Training Expiration Date: ��018 Instructor Name: R��k Todd Instructor Number: ��$ J Pinal Patel has successfully completed the NSC CPR Course based on the current Guidelines for CPR and ECC. , The Natic?nal Safety Council saves lives by preventing injuries and deaths at work,in homes and communities and on the roads through leadership,research,education and advocacy. For more life-saving courses from NSC please visit nsc.org/fatraining � THIS DOCUMENT IS VOID IF REPRODUCED � __._ _ _ ,: ___. _ - ---- - -- - - - - _ _ � _ _ Security Control No. � Pina1 Patei 16 9 0 9 9 � M has completed the ° NSC CPR Course Your experience in the National Safety Council ° . CPR,Ad�,M,Child,Infant 8 AED couse you took is very important to us. Train�n9 center: Cape Cod Safety Tra�ing Please give us your feedback at compiet�on�ate: 1oR812016 ' nsc.org/firstaidevaluation Expires: ��98 Instructional Hours: 3 hf �.`y':',s-� �1040918 Instructor Signature Instructor No. N.S .�i-in it for life° nsc.org/fatraining '� • • • • • � • • •• �• -� 300M0316 1015 900008130�2016 National Safety Council 797 74-0�0