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AGENCY CUSTOMER ID: LIRSCOR
<br />LOC #: San Francisco
<br />`► o ADDITIONAL REMARKS SCHEDULE
<br />Page 2 of 2
<br />AGENCY
<br />NAMEDINSURED
<br />MARSH RISK & INSURANCE SERVICES
<br />URS Corporation
<br />dba URS Corporation Arnericas
<br />2020 E. First Street, Suite 400
<br />POLICY NUMBER
<br />Santa Ana, CA 92705
<br />CARRIER
<br />NAIC CODE
<br />EFFECTIVE DATE:
<br />ADDITIONAL REMARKS
<br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
<br />FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance
<br />The Workers' Compensation coverage shown does not apply in monopolistic stales In the States of ND, OH, WA and WY Workers' Compensation coverage is provided by the Stale Fund. In those States, the above -
<br />referenced policies provide Slop Gap Employers' Uability only. Workers Compensation policies apply as indicated below.
<br />Insurer A: National Union Fire Ins Co Pittsburgh, PA NAIC# 19445100
<br />WC 021417576 - CA
<br />Insurer D: tnsurance Company Of The State Of PA NAIC# 19429100
<br />WC 021417580 - MA, WI (Stop Gap - NO, OH, WA, WY)
<br />WC 021417581 - AK At, AR, A2, CO, DE, GA, ID, KS, KY, MD, ME, MO. MS, MT, NC, NH, NM, NV, OK, OR, PA, RI, SC, SD, TN, UT, VA, VT, WV
<br />WC 021417685 - MN
<br />WC 021417578 - NY
<br />Insurer C: Illinois National Ins Co NAIC# 23817001
<br />WC 021417577 - FL
<br />WC 021417582 - CT, DC, HI, IA, IL, IN, LA, MI, NE, NJ
<br />WC 021417579 -TX
<br />AGUKU lul ILUUtImi) (D 2008 ACORD CORPORATION, All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
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