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AGENCY CUSTOMER ID: _ LOC#: A ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED Marsh JLT SpecialtyUSA Gregqg Drilling LLC 2726 Walnut Avenue POLICY NUMBER Signal Hill CA 90755 SP002682-03-2019 CARRIER NAIC CODE AXIS Surplus Insurance Company 26620 EFFECTIVE DATE:8/1/2019 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE:Certificate of Liability(03/16) HOLDER: Geosyntec Consultants ADDRESS: 3043 Gold Canal Drive Suite 100 Rancho Cordova CA 95670 The certificate holder Geosyntec Consultants, its affiliates, employees, volunteers, contractors, subcontractors, consultants, agents, representatives, directors, officers, officials are all additional insured on the General, Automobile, Contractors Pollution and 1 Excess Liability policies where required by written contract or agreement subject to policy terms, conditions and exclusions. Professional Liability is claims made. Per Project General Aggregate excludes Professional Liability. Umbrella is excess over General Liability, Pollution and Professional Liability, Automobile and Employer' s Liability coverages. This Insurance is Primary and Non-Contributory on the General, Automobile and Employer Liability policy subject to the policy terms, conditions and exclusions . Waiver of subrogation applies in favor of the certificate holder Geosyntec Consultants, its affiliates, employees, volunteers, contractors, subcontractors, consultants, agents, representatives, directors, officers, officials are all on the General, Automobile, Workers Compensation, Contractors Pollution and Excess Liability policies where required by written contract or agreement . 30 days notice of cancellation / 10 days for non-payment of premium. ACORD 101 (2008101) 02008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ADDENDUM 5101/096 119-20 GL-AWO-FG%5-CPL-PROF I Phyllis .loh...n 1 9/6/2019 2:23:12 PM (PM) I Page 2 of 14