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Policy Change <br />Number <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />POLICY CHANGES <br />THIS ENDORSEMENT FORMS A PART OF THE POLICY NUMBERED BELOW: <br />POLICY NUMBER <br />POLICY CHANGES <br />COMPANY <br />EFFECTIVE <br />3602AH025251 • 11 <br />11-05-2018 <br />Markel Insurance Company <br />NAMED INSURED <br />AUTHORIZED REPRESENTATIVE <br />Beginners Edge Sports Training dba SoccerTots <br />Bruce A. Kay <br />Lil Sluggers Baseball & Slam Dunkerz Basketball <br />COVERAGE PARTS AFFECTED <br />CHANGES <br />The following has been added to the policy as an additional insured: <br />City of Santa Ana Parks, Recreation and Community Services Agency <br />1825 W Civic Center Dr. <br />Santa Ana, CA 92703 <br />Form CG2001 is added to the policy, but only with respect to the <br />above additional insured. <br />All other terms and conditions remain unchanged. <br />t� <br />(;B,CiYIG'O(?,eCC��ttO� <br />,,CS <br />The above amendmentls) result in a change in premium as follows: <br />NO CHANGES <br />❑ TO BE ADJUSTED <br />ADDITIONAL <br />RETURN PREMIUM <br />AT AUDIT <br />PREMIUM <br />S 0.00 <br />$ <br />Bruce A, Kay <br />Authorized Representative S nature <br />AU IL 12 01 11 85 Copyright, ISO Commercial Risk Services, Inc., 1983 10-31-2018 <br />