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ACO DR
<br />11*../
<br />AGENCY
<br />MARSH RISK 8 INSURANCE SERVICES
<br />POLICY NUMBER
<br />CARRIER
<br />AGENCY CUSTOMER ID: URSCOR
<br />LOC #: San Francisco
<br />ADDITIONAL REMARKS SCHEDULE
<br />NAMED INSURED
<br />URS Corporation
<br />dba URS Corporation Americas
<br />2020 E. First Skeet, Suite 400
<br />Santa Ana, CA 92705
<br />NAIC CODE
<br />EFFECTIVE DATE:
<br />AUL/11IUNAL Kt:MARKS
<br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
<br />FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance
<br />Page 2 of 2
<br />The Workers Compensation coverage shown does not apply In monopolistic states. In the States of No, OH, WA and WY Workers Compensation coverage Is provided by the State Fund. In those States, the above -
<br />referenced policies provide Stop -Gap Employers' Liab lity only. Workers Compensation policies apply as indicated below:
<br />Insurer A: National Union Fire Ins Co Pittsburgh, PA NAIC# 19445100
<br />WC 021417576 - CA
<br />Insurer D: Insurance Company Of The State Of PA NAIC# 119429100
<br />WC 021417580 - MA, WI (Stop Gap - NO, OH, WA, WY)
<br />WC 021417581 - AK AL, AR, AZ, CO, DE, GA.10, KS, KY, MD, ME, MO, MS, MT, NC, NH, NM, NV, OK, OR, PA, RI, SC, SD, TN, UT, VA, VT, WV
<br />WC 021417585 - MN
<br />WC 021417578 -NY
<br />Insurer C: Illinois National ins Co NAIC# 23817001
<br />WC 021417577 - FL
<br />WC 021417582 - CT, DC, HI, IA, IL, IN, LA, MI, NE, NJ
<br />WCOA417579 -TX
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<br />--- - v ZUVIS ACUKU GOKPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
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