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A4 020' <br />L--� <br />AGENCY CUSTOMER ID: 06510 <br />LOC a: Los Angeles <br />ADDITIONAL REMARKS SCHEDULE <br />Page 5 of 5 <br />AGENCY <br />NAMED INSURED <br />Marsh Rsk B Insurance Services <br />AECOM Technical Service, Inc <br />(I.k a. (WOM Hams) <br />999 Tom and Country <br />POLICY NUMBER <br />Orange, CA 92868 <br />CARRIER <br />NAICCODE <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 />ADDITIONAL INSURED -DESIGNATED PERSONS OR ORGANIZATIONS <br />Named Insured: AECOM Techncal Service, Inc. (Na. OWN Hams) <br />Policy Symbol Policy Number Poky Period Effective Date of Endorsement <br />BAP 5965893 04 411112 to 4l3 <br />Issued By W596589304 41112012-411r2013 411112 <br />)Name of Insurance Company) Zurich American Insurance Company <br />THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY <br />This endorsement modifies insurance provided under the following. <br />BUSINESS AUTO POLICY <br />TRUCKERS POLICY <br />GARAGE POLICY <br />Addroona' Insured (s) <br />The City of Santa Ana <br />Public Works Design Engmeenrig <br />20 Civic Center Raze <br />Santa Ana, CA 92701 <br />CONTRACT NO. A2008-216, ON CALL CONTRACT FOR ENGINEERING AND LANDSCAPING DESIGN SERVICES (AECOM CONTRACT N0. 60100544) <br />THE CITY OF SANTA ANA, CA, ITS OFFICERS, EMPLOYEES <br />ANY AUTO <br />A, For a covered'auto,'Who is Insured is changed to inckde as an 'insured ' the persons or organizations named in this endorsement. However lllesepersons or organizalions are an'ins'ured' only for "bodily injury' <br />of *property damage' resulting from acts or caissons of: <br />1. You <br />2 Any of your employees or agent. <br />3. Any person operating a covered'auto with permission from You, any of your employees or agents. <br />B. The persons or organizations named in this endorsement are not liable for payment of your premium <br />CA 2048 02 99 <br />2008 ACORD CORPORATION. All riahts reserved - <br />The ACORD name and logo are registered marks of ACORD <br />