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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />POLICY CHANGES <br />t-ollicy unan a Number 2 <br />POLICY NUMBER POLICY CHANGES COMPANY <br />HBD 10015218 3 EFFECTIVE Hudson Specialty Insurance Company <br />09/09/2019 <br />NAMED INSURED <br />COVERAGE PARTS AFFECTED <br />General Liability <br />AUTHORIZED REPRESENTATIVE <br />CHANGES <br />FOLLOWING ADDITIONAL INSURED IS HEREBY ADDED PER FORMS CG2015,CG2010 AND HUD-GL- <br />CITY OF SANTA ANA, ITS OFFICERS, AGENTS AND EMPLOYEES <br />20 CIVIC CENTER PLAZA <br />SANTA ANA, CA 92701 <br />FOLLOWING FORMS ARE HEREBY ADDED: <br />CG2010 <br />HUD-GL-2006 <br />PREMIUM CHANGE $ 402.00 <br />OTHER CHARGES <br />Surplus lines Tax $ 12 00 <br />Stamping Fee $ 0.80 <br />Total: <br />$ 412.80 <br />HUD -IL 2003 0912 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 <br />with its permission <br />0 <br />