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AGENCY CUSTOMER ID:
<br />LOC #:
<br />ADDITIONAL REMARKS SCHEDULE
<br />AGENCY
<br />Arthur J. Gallagher Risk Management Services, Inc.
<br />POLICY NUMBER
<br />14627210
<br />CARRIER
<br />Lexington Insurance Company
<br />NAMED INSURED
<br />RailWorks Track Services, Inc.
<br />12740 Lakeland Road
<br />Santa Fe Springs CA 9070
<br />NAIC CODE
<br />19437 EFFECTIVE DATE:
<br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
<br />FORM NUMBER:
<br />28 FORM TITLE: EVIDENCE OF COMMERCIA
<br />Page 1 Of 1
<br />Id - $100,000 per Occurrence, except as follows:
<br />as
<br />Federal
<br />, subject to a minimum of 00 any one occurrence,ral Emergency Management
<br />of Total Insurable Values at the time of the loss at each location involved in the loss or damagee
<br />,Pris locations wholly or partially within Special Flood Hazard Areas (SFHA), areas of 100-year flooding, as defined by the FFedent
<br />Earthquake - $100,000 per Occurrence, except as follows:
<br />5 % of Total Insurable Values at the time of the loss at each location involved in the loss or damage, subject to a minimum of $500,000 any one occurrence, as
<br />respects locations in California, Alaska, Hawaii and/or Puerto Rico
<br />5% of Total Insurable Values at the time of the loss at each location involved in the loss or damage, subject to a minimum of $250,000 any one occurrence, as
<br />respects locations in the New Madrid Earthquake Zone Counties
<br />5 % of Total Insurable Values at the time of the loss at each location involved in the loss or damage, subject to a minimum of $250,000 any one
<br />occurrence, as respects locations in the Pacific Northwest Earthquake Zone Counties
<br />,storm - $100,000 Per Occurrence, except as follows:
<br />Typhoon Tropical Cyclone, Tropical Storm or Tropical Depression),
<br />of Total Insurable Values at the time of the loss at each location involved in the loss a damage arising out of a Name
<br />.m (a storm that has been declared by the National Weather Service to be a Hurricane, Typ P
<br />udless of the number of Coverages, Locations or Perils involved (including but not limited to, all Flood, wind, wind gusts, storm surges, tornados, cyclones,
<br />or rain) and subject to a minimum deductible of $250,000 any one occurrence Tropical Cyclone,
<br />Occurrence for the peril of Named Storm (a storm that has been declared by the National Weather Service to be a Hurricane, Typhoon, p , Y
<br />pica/ Storm f Tropical Depression) in Tier 1 Counties, regardless of the clones, hob orrain).Coverages, Locations or Perils involved (including but not limited to, all
<br />od, (however caused) wind, wind gusts, storm surges, tornados, cyclones,
<br />: Property located at 1000 East Santa Ana Boulevard In the City of Santa Ana, Suite#106.
<br />/ of Santa Ana Is include as Loss Payee.
<br />101 (2008/01)
<br />The ACORD name and logo are registered marks of ACORD
<br />REVIEWED & APPROVED BY:
<br />A+fZ Acwalo
<br />Ruk Management Spedrist
<br />
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