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AGENCY CUSTOMER ID: 33004588 <br />LOC #: <br />A` °R°® ADDITIONAL REMARKS SCHEDULE <br />Page 2 of 2 <br />AGENCY <br />NAMED INSURED <br />Atkins North America, Inc. <br />Willis of <br />New York, Inc. <br />2001 NW 107th Avenue <br />Miami, FL 33172 -2507 <br />POLICY NUMBER <br />See First <br />Page <br />CARRIER <br />NAIC CODE <br />See First <br />Page <br />EFFECTIVEDATE: See First Page <br />AUU1 11V1YAL 11CMmmr.. <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE <br />Re: Combined Project Study Report /Project Report (PSR /PR), Environmental Document (ED) and PS &E <br />preparation for the SR -55 7MacArthur Blvd. Interchange Ramp Widening Project, Project Number: <br />07 -2503. <br />Coverage for Contractual Liability is provided under the Automobile Liability policy. <br />The General Liability policy includes a Severability of Interest Clause. <br />The City of Santa Ana, its officers, agents, representatives, volunteers and employees are <br />included as Additional Insureds as respects to General Liability and Auto Liability. <br />General Liability and Auto Liability policies shall be Primary and Non - Contributory with any other <br />insurance in force for or which may be purchased by Additional Insureds. <br />Waiver of Subrogation applies in favor of Additional Insureds with respects to General Liability, <br />Auto Liability and Workers Compensation policies permitted by law. <br />Umbrella policy is Follow Form. <br />1pl:.LolU /U1 uerr:lybsy414 U200SAGORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />