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ACORO® <br />AGENCY CUSTOMER ID: 06510 <br />LOC #f: Los Angeles <br />ADDITIONAL REMARKS SCHEDULE <br />Page 3 of 5 <br />AGENCY NAMED INSURED <br />Marsh Risk & Insurance Services AECOM Technical Service, Inc. <br /> (fk <br />DMJM Harris) <br />a <br />POLICY NUMBER . <br />. <br />999 Town and Country <br /> Orange, CA 92868 <br />CARRIER NAIC CODE <br /> EFFECTIVE DATE: <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance <br />Waiver of Transfer Of Rights Of Recovery Against Others To US <br />POLICY NUMBER BAP 5965893 04 Eff. Date of Pd. - Exp. Date of Pol. Eff. Date of End Agency No. Addl. Prem Return Prem <br />411/13 4)1112 <br />This endorsement is issued by the company named in the Declarations. It changes the policy on the effective dale listed above at the hour staled in the Declarations. <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />Named Insured <br />AECOM Technical Service, Inc. (f.k.a. DMJM Harris) <br />This endorsement modifies. insurance provided under: <br />BUSINESS AUTO COVERAGE FORM <br />MOTOR CARRIERS COVERAGE FORM <br />TRUCKERS COVERAGE FORM <br />GARAGE COVERAGE FORM <br />SCHEDULE <br />Name of Person or Organization: <br />The City of Santa Ana <br />Public Works Design Engineering <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />CONTRACT NO A-2008-216, ON-CALL CONTRACT FOR ENGINEERING AND LANDSCAPING DESIGN SERVICES (AECOM CONTRACT NO 60100544) <br />THE CITY OF SANTA ANA, CA, ITS OFFICERS, EMPLOYEES <br />411112- <br />We waive any right of recovery we may have against the designated person or organization shown in the schedule because of payments we make for injury or damage caused by an "accident' or "loss' resulting from the <br />ownership, maintenance, or use of a covered 'auto' for which a Waiver of Subrogation is required in conjunction with work performed by you for the designated person or organization. The waiver applies only to the <br />designated person or organization shown in the schedule. <br />U-CA-320-BCW (4194) Page 1 of 1 <br />ACORn 1n1 tinnwn1\ <br />yr cuVO AF,VMLP GVKlf'VFIA I-IVN. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD