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4C0 <br />AGENCY CUSTOMER ID: <br />LOC #: <br />ADDITIONAL REMARKS SCHEDULE <br />AGENCY <br />Willis Towers Watson Northeast, Inc. <br />POLICY NUMBER <br />See Page i <br />CARRIER <br />See Page 1 <br />NAMED INSURED <br />GHD Inc. <br />4747 N. 22nd Street, Suite 200 <br />Phoenix, AZ 85016 <br />NAIC CODE <br />See Page 1 EFFECTIVE DATE: See Page 1 <br />Page 2 of 2 <br />AUDI I1UNAL NtMAKKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance <br />City of Pleasanton, its officers, employees and agents are included as Additional Insureds as respects to General <br />Liability and Umbrella/Excess Liability where required by contract or agreement. <br />Waiver of Subrogation applies in favor of Additional Insureds with respects to General Liability and Umbrella/Excess <br />Liability, where required by contract or agreement. <br />ACORD 101 (2008/01) ® 2008 ACUHU GUHPUHA I IUN. AO rlgnts reservea, <br />The ACORD name and logo are registered marks of ACORD <br />SR ID: 26008438 SATCH:3501447 CERT: w33881118 <br />3437: 2 of 4 <br />