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AGENCY CUSTOMER ID: <br /> LOC#: <br /> AC R i ADDITIONAL REMARKS SCHEDULE Page 2 of 2 <br /> AGENCY NAMED INSURED <br /> Willis Towers Watson Northeast, Inc. Fieldturf USA, Inc. <br /> C/o Sports Division <br /> POLICY NUMBER Tarkett Inc. <br /> See Page 1 7445 Cote-de-Liesse Road, Suite 200 <br /> Montreal, QC N4T 1G2 CAN <br /> CARRIER NAIL CODE <br /> See Page 1 See Page 1 EFFECTIVE DATE: See Page 1 <br /> ADDITIONAL REMARKS <br /> THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br /> FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance <br /> WC Policies: <br /> Policy # UB-8P793534-25-51-K - covers all other states. <br /> Policy # UR-8P760619-25-51-R - covers AZ, MA, WI only. <br /> City of Santa Ana, its City Council, officers, officials, employees, agents, and volunteers are included as Additional <br /> Insured on the General Liability, Automobile Liability, Excess/Umbrella Liability policy, as respects to ongoing and <br /> completed operations performed on the project specified in the construction contract for the period of time required <br /> within the contract. <br /> It is further agreed that such insurance as is afforded shall be Primary and Non-contributory with any other insurance <br /> in force for or which may be purchased by the Additional Insured, where required by written contract executed prior to <br /> loss and permitted by law. <br /> Waiver of Subrogation applies in favor of City of Santa Ana, its City Council, officers, officials, employees, agents, <br /> and volunteers with respects to General Liability, Automobile Liability, Excess/LYmbrella Liability Policy and Workers <br /> Compensation coverage where required by written contract subject to policy terms and conditions and as permitted by <br /> law. <br /> INSURER AFFORDING COVERAGE: Berkley Assurance Company NAIC#: 39462 <br /> POLICY NUMBER: PCAB-5C30451-0226 EFF DATE: 02/15/2026 EXP DATE: 02/15/2027 <br /> TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: <br /> Professional Liability Aggregate $2,000,000 <br /> Per Claim $2,000,000 <br /> SIR $250,000 <br /> ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br /> SR ID: 29589925 BATCH: 4369005 CERT: W44772348 <br />