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* S1 * 03/18/2019 * PAC 2903161 00 GREAT AMERICAN INSURANCE COMPANY <br />*D/B* 426394872 0694803 <br />IL 70 02 (Ed. 10/07) <br />Policy No. PAC 2903161 00 <br />Effective Date of Change 04/28/2019 <br />POLICY CHANGES <br />NAMED INSURED CENTRO CULTURAL DE MEXICO EN <br />EL CONDADO DE ORANGE; KAREN <br />AND ADDRESS: P.O. BOX 133 <br />SANTA ANA, CA 92701 <br />THIS ENDORSEMENT <br />CHANGES THE POLICY. <br />PLEASE READ IT <br />CAREFULLY. <br />POLICY ALTERNATE MAILING ADDRESS: AGENT'S NAME AND ADDRESS: <br />BAKER, ROMERO & ASSOC. <br />750 TERRADO PLZ STE 238 <br />COVINA, CA 91723 3412 <br />Insurance is afforded by the Company named below, a Capital Stock Corporation: <br />GREAT AMERICAN INSURANCE COMPANY <br />POLICY PERIOD: From 11/28/2018 To 11/28/2019 <br />12:01 A.M. Standard Time at the address of the Named Insured <br />IT IS HEREBY UNDERSTOOD AND AGREED THAT THIS POLICY IS AMENDED AS FOLLOWS: <br />WITH RESPECTS TO GENERAL LIABILITY FORM CG 2026 ADDITIONAL INSURED WAS ADDED <br />TO THE POLICY: <br />CITY OF SANTA ANA <br />SANTA ANA, CA <br />THE FOLLOWING SPECIAL EVENT HAS BEEN ADDED: <br />DIA DEL NINO ON APRIL 28TH <br />ANY AMENDED FORMS ATTACHED TO THIS CHANGE DISPLAY PREMIUMS FOR A FULL POLICY TERM. <br />IL 70 02 (Ed. 10/07) <br />Forms and Endorsement Activity <br />(Page 1 of 2) <br />i <br />