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TRAVELERS WORKERS COMPENSATION <br />AND <br />EMPLOYERS LIABILITY POLICY <br />ENDORSEMENT WC 99 06 11 (A) <br />POLICY NUMBER: TRJUB-4245B231-12 <br />TC2JUB-4245B22A-12 <br />NOTICE OF CANCELLATION <br />Except for non-payment of premium by you, we agree that no cancellation or limitation of this policy shall <br />become effective until the number of days written notice specified in item 2 of the Schedule has been <br />mailed to you and to the person or organization designated in item 1 of the Schedule at the address <br />indicated. <br />SCHEDULE <br />1. Name: Any person or organization to whom you have agreed in a written contract that notice of cancellation or <br />material limitations of this policy will be given but only if: <br />1. You send us a written request to provide such notice, including the name and address of such person or <br />organization, after the first Named Insured receives notice from us of the cancellation or material limitation of <br />this policy; and <br />2. We receive such written request at least 14 days before the beginning of the applicable number of days <br />shown in this Schedule. <br />Address: The address for that person or organization included in such written request from you to us <br />2. Number of Days Written Notice: 30 Additional Days <br />City of Santa Ana Public Works Agency Jason Gabriel <br />20 Civic Center Plaza, M-36 <br />Santa Ana, CA 92701 <br />This endorsement changes the policy to which it is attached and is effective on the date issued unless <br />otherwise stated. <br />(The information below is required only when this endorsement is issued subsequent to <br />preparation of the policy.) <br />Endorsement Effective: 4/1/2012 Policy No. TRJUB-4245B231-12 Endorsement No. <br />TCULIB-4245622A-12 <br />Insured AECOM Technology Corporation AECOM Technical Premium $ <br />Services, Inc. <br />Insurance Company Travelers Property Casualty Co of America <br />Page 1 of 1 <br />Attachment Code: D461827 <br />Master ID: 1075642, Cenifioate ID: 11729371 <br />