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10nPoint Undewiting Inc. <br />POLICY NUMBER <br />RWC C48101562 <br />AGENCY CUSTOMER In <br />LOC: #' <br />ADDITIONAL REMARKS SCHEDULE Pace 2 of <br />Barrett Business Services, Inc, L/CIF <br />CALIFORNIA PROFESSIONAL ENGINEERING INC, <br />929 OTTERBEIN AVE UNIT E <br />ROWLAND HEIGHTS, CA 01748 <br />IACE American Insurance Company 22667 JEFFECTIVE DATE: 12119/14 <br />ADDITIONAL REMARKS <br />— -- - -- ------- <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: Certificate of Liability (01114) <br />CERTIFICATE HOLDER: City of Santa Ana <br />ADDRESS: 20 Civic Center Plaza Santa Ana CA 92701 <br />All Operations <br />ACORD 101 (2008101) c) 1988-2010 ACORD CORPORATION, All fights reserved. <br />The ACORD name and logo are registered marks of ACORD. <br />CALIFORNIA PROFESSIONAL ENGINEERING A-2015-090 REVIEWED BY. 4 EUNICE HEREDIA (PG 7 OF 7) <br />