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AGENCY CUSTOMER ID:
<br />LOC #:
<br />ADDITIONAL REMARKS SCHEDULE
<br />AGENCY
<br />Arthur J. Gallagher Risk Management Services, Inc.
<br />POLICY NUMBER
<br />14627210
<br />CARRIER
<br />Lexington Insurance Company
<br />NAMED INSURED
<br />RailWorks Track Services, Inc.
<br />12740 Lakeland Road
<br />Santa Fe Springs CA 9070
<br />NAIC CODE
<br />19437 EFFECTIVE DATE: 04101
<br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO OFCCORD F R M,
<br />EVIDENC
<br />FORM NUMBER: 28 FORMTITLE:
<br />Page 1 of 1
<br />- $100,000 per occurrence, except as follows:
<br />Total Insurable Values at the time of the loss at each location involved in the loss or damage, sub ingact to a minimum of Fe0 e00 any one occurrence, e
<br />its locations wholly or partially within Special Flood Hazard Areas (SFHA), areas of 100-year Hooding, as defined by the Federal Emergency Management
<br />rthquake - $100,000 per Occurrence, except as follows:
<br />u of Total Insurable Values at the time of the loss at each location involved in the loss or damage, subject to a minimum of $500,000 any one occurrence. as
<br />;peck locations in California, Alaska, Hawaii andlor Puerto Rico
<br />i, of Total Insurable Values at the time of the loss at each location involved in the loss or damage, subject to a minimum of $250,000 any one occurrence, as
<br />spects locations in the New Madrid Earthquake Zone Counties
<br />% of Total I s urable Values at the
<br />in time
<br />of the loss at each location involved
<br />Northwest Earthquake Zone in the loss or damage, subject to a minimum of $250,000 any one
<br />nce,
<br />respects
<br />ons
<br />the
<br />lstorm - $100,000 Per Occurrence, except as follows:
<br />m (o storm that has been declared by the National Weather Service to be a Hurricane, Typhoon, Tropical Cyclone, Tropical Storm or Tropical Depression),
<br />�f Total Insurable Values at the time of the loss at each location involved in the loss or damage arising out of a Name
<br />irdless of the number of Coverages, Locations or Perils involved (including but not limited to, all Flood, wind, wind gusts, storm surges, tornados, cyclones,
<br />or rain) and subject to a minimum deductible of $250.000 any one occurrence hoop, Tropical Cyclone,
<br />Occurrence for the peril of Named Storm (a storm that has been declared by the National Weather Service to be a Hurricane, clu P
<br />3ical Storm or Tropical Depression) in Tier 1 Counties, regardless of the number of Coverages, Locations or Perils involved (including but not limited to, all
<br />A (however caused) wind, wind gusts, storm surges, tornados, cyclones, hail or rain).
<br />of Santa Anat sdin t 1000 East Santa
<br />as Loss Payee. a Boulevard in the City of Santa Ana, Suite#106.
<br />ude
<br />The ACORD name and logo are registered marks of ACORD
<br />RENEWED & APPRCAIID BY:
<br />A+V Auu4le
<br />Risk Management specialist
<br />
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