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AGENCY CUSTOMER ID: 06510 <br />LOC #: Los Angeles <br />ACo ® ADDITIONAL REMARKS SCHEDULE Page 4 of 5 <br />AGENCY NAMED INSURED <br />Marsh Risk 8 Insurance Services AECOM Technical Service, Inc. <br />(f.k.a. DMJM Hams) <br />POLICY NUMBER 999 Town and Country <br />Orange, CA 92868 <br />CARRIER 714AIC 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 />POLICY NUMBER: GLO 5965891 04 COMMERCIAL GENERAL LIABILITY <br />CG 20 26 0104 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED - DESIGNATED <br />PERSON OR ORGANIZATION <br />This endorsement modifies insurance provided under the following <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />Name Of Additional Insured Person(s) Or Organizations(s) <br />The City of Santa Ana <br />Public Work3 Design Engineering <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />CONTRACT NO. A-2008-216, ON -CALL CONTRACT FOR ENGINEERINGAND LANDSCAPING DESIGN SERVICES (AECOM CONTRACT NO.60100544) <br />THE CITY OF SANTA ANA. CA, ITS OFFICERS, EMPLOYEES <br />Information required to complete this Schedule, if not shown above, will be shown in the Declarations <br />Section II - Who is An Insured is amended to include as an additional insured the person(s) ororganizabon(s) shown in the Schedule, but only with respect to liability for 'bodily injury', "property damage' or "personal and <br />advertising injury' caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: <br />A. In the performance of your ongoing operations; or <br />B. In connection with your premises owned by or rented to you. <br />CG 20 26 0104 <br />POLICY NUMBER: BAP 5965893 04 <br />Ar^nRn ini zonnnrnn <br />- - 1 wr ZUva AL;UKU WHPUKATK)N. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />