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AGENCY CUSTOMER ID: <br />LOC: #: <br />`64�­ AL)LA I 1UNAL KtMAKMS SCMEDULE Page 2 of 2 <br />AGENCY NAMEDINSURED <br />Barrett Business Services, Inc. <br />OnPoint Underwriting Inc. <br />8100 NE Parkway, Suite 200 <br />POLICY NUMBER Vancouver WA 98662 <br />RWC C48554647 <br />CARRIER NAIC CODE <br />ACE American Insurance Company 22667 EFFECTIVE DATE: 12/01/15 <br />L" i IVIVNL MCIVIMMMO <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: Certificate of Liability (01/14) <br />CERTIFICATE HOLDER: City of Santa Ana <br />ADDRESS: 20 Civic Center Plaza Santa Ana CA 92701 <br />Design-Build High Voltage Street Lighting System, Agreement # A-2015-208 <br />I 1LVuu/v 1) G) I t)OO-ZU I U 1AUUNU UUKI-UF<A I IUM All rights reserved. <br />The ACORD name and logo are registered marks of ACORD. <br />REVIEWED BY: EUNICE HEREDIA (PG <br />