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AGENCY CUSTOMER ID: 06510 <br />LOC #: Los Angeles <br />'`?C R0 0® ADDITIONAL REMARKS SCHEDULE Page 5 of 5 <br />AGENCY NAMED INSURED <br />Marsh Risk 8 Insurance Services AECOM Technical Service, Inc. <br /> (f <br />k <br />a <br />DMJM Hams) <br />POLICY NUMBER . <br />. <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 />ADDITIONAL INSURED-DESIGNATEDPERSONS OR ORGANIZATIONS <br />Named Insured: AECOM Technical Service, Inc. (f.k.a. DMJM Hams) <br />Policy Symbol Policy Number Policy Period Effective Date of Endorsement <br />BAP 5965893 04 411/12 to 4/1113 <br />Issued By BAP 596589304 41112012-411013 411112 <br />(Name of Insurance Company) Zurich American Insurance Company <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY <br />This endorsement modifies insurance provided under the following: <br />BUSINESS AUTO POLICY <br />TRUCKERS POLICY <br />GARAGE POLICY <br />Additional Insured (s): <br />The City of Santa Ana <br />Public Works Design Engineenng <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 />ANY AUTO <br />A. For a covered 'auto.' Who Is Insured is changed to include as an 'insured' the persons or organizations named in this endorsement. However, these persons or organizations are an 'inured" only for "boddy injury' <br />or *property damage' resulting from acts or omissions of: <br />1. You. <br />2. Any of your employees or agents, <br />3 Any person operating a covered 'auto' with permission from You, any of your employees or agents. <br />B. The persons or organizations named in this endorsement are not liable for payment of your premium <br />CA 20 48 02 99 <br />ACORD 101 1200EUn1I <br />'w cwo A%.Unu wrrrUKA FION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD