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AGENCY CUSTOMER ID: 645175
<br />LOC#:
<br />AC'ORL7®
<br />GENCY
<br />ADDITIONAL REMARKS SCHEDULE Page-1-of 2
<br />NAMED INSURED
<br />URS Corporation dba URS Corporation Americas
<br />Tillie Insurance Services of California, Inc. 2020 E. First Street, Suite 400
<br />OLICY NUMBER
<br />tee First P
<br />ARRIER
<br />lee First P
<br />NAIC CODE
<br />Santa Ana, CA 92705
<br />EFFECTIVE WE:
<br />'HIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
<br />ORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE
<br />corkers Compensation policies apply as indicated below:
<br />IC20635051 - CA
<br />rC20635052 - FL
<br />rC20635053 - TX
<br />rC20635054 - AX, AL, AZ, DC, DE, HI, IA, IL, IN, KS, LA, DID, ME, MI, MO, MS, MT, NC, NE, NH, NJ,
<br />IM, OX, PA, RI, SC, SD, TN, VA, VT
<br />rC20635055 - AR, CO, CT, GA, ID, XY, MA, MN, ND, NV, NY, OH, OR, UT, WA, WI, WV, WY
<br />'he City of Santa Ana, its officers, employees, agents, volunteers and representatives are incl
<br />Is Additional Insureds as respects the General Liability policy, where required by written coat
<br />'his insurance is Primary over any similar insurance available to any person or organization we
<br />Lave added to this policy as Additional Insureds.
<br />â–ºCORD101 (2008/01) Coll:3376174 Tp1:1261289 Cert:16028973®2008ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
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