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CIZXCGCOH 10-07 <br />-06A_ <br />Fireman's <br />F and <br />POLICY NUMBER 8 H4 AZC 8092 89 80 <br />NATIONAL SURETY CORPORATION, CHICAGO, IL (07) <br />Named Insured <br />SERRANO ANIMAL & BIRD HOSPITAL,WELD <br />AMERICAN BUSINESS COVERAGE CHANGE ENDORSEMENT <br />Effective 07/01/19, 12:01 A.M., <br />Standard Time at the address of the insured <br />Sequential Endorsement Number 002 <br />This is an Endorsement only. Other than changes shown, all other pre-existing <br />coverage remains in full force and effect. Premium adjustments are shown. <br />PREMIUM SUMMARY: ADDITIONAL PREMIUM DUE NOW $0.00 <br />Terrorism Risk Insurance Act ("The Act") - Certified Acts Coverage - <br />All Coverages Subject to the Act Excl WC and Umbrella - <br />Covered $0.00 <br />THE FOLLOWING CHANGES APPLY TO PROPERTY/LIABILITY COVERAGE <br />ADDITIONAL INSURED - OWNERS, LESSORS OR CONTRACTORS (AB 90 67 12 93) <br />ENDORSEMENT IS ADDED AND APPLIES AS FOLLOWS: <br />A/I NO. 02 • LOC 002 <br />NAME: CITY OF SANTA ANA ITS OFFICERS, AGENTS AND EMPLOYEES, <br />RISK MANAGEMENT DIVISION <br />STREET: 20 CIVIC CENTER PLAZA, 4TH FLOOR <br />CITY: SANTA ANA ST: CA ZIP CODE: 92702 <br />Forms Added at the Inception of this Change Endorsement <br />PROPERTY/LIABILITY <br />AB9067 12-93 <br />Countersignature of Authorized Agent: <br />Producer VETERINARY INS., SERVICES CO <br />1400 RIVER PARK DR STE 180 <br />SACRAMENTO CA 95815 <br />E OF CHANGE ENDORSEMENT <br />Date 09/03/19 <br />Page 1 <br />