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AGENCY CUSTOMER ID <br />LOG: #: <br />0 C<:>R � <br />ADDITIONAL REMARKS SCHEDULE Page 2 of 2 <br />AGENCY NAMEDINSURED <br />Barrett Business Services, Inc. L/C /F <br />OnPoint Underwriting Inc. CALIFORNIA PROFESSIONAL ENGINEERING INC. <br />POLICY NUMBER 929 OTTERBEIN AVE UNIT E <br />RWC 048101562 ROWLAND HEIGHTS, CA 91748 <br />CARRIER INAIC CODE <br />ACE American Insurance Company 22667 EFFECTIVE DATE: 12/19/14 <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: Certificate of Liability (01/14) <br />ADDRESS: 20 Civic Center Plaza Santa Ana CA 92701 <br />1 Operations. <br />ACORD 101 (2002 /01) <br />The ACORD name and logo are registered marks of ACORD. <br />All riahts reserved <br />CALIFORNIA PROFESSIONAL ENGINEERING A- 2015 -090 REVIEWED BY EUNICE HEREDIA (PG 7 QF 7) <br />