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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />POLICY CHANGES <br />Policy Change <br />Number 01 <br />POLICY NUMBER <br />POLICY CHANGES <br />COMPANY <br />EFFECTIVE <br />Mesa Underwriters Specialty <br />MP0004014001102 <br />03/06/2020 <br />Insurance Company <br />NAMED INSURED <br />AUTHORIZEbflEPREPqTATIVE <br />ROBERTO ZAVALA-COSMOS EVENT RENTAL <br />04014 <br />AmWINS Access Insurance Services, L <br />COVERAGE PARTS AFFECTED <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />COMMERCIAL PROPERTY COVERAGE PART <br />IN CONSIDERATION OF AN ADDITIONAL PREMIUM OF $150. IT IS <br />HEREBY AGREED THAT THE FOLLOWING FORMS ARE <br />ADDED TO THE POLICY: <br />CO 20 01 - PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE <br />CONDITION <br />CG 20 10 - ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION <br />CITY OF SANTA ANA <br />RISE MANAGEMENT DIVISION, 4TH FLOOR <br />CIVIC CENTER PLAZA <br />SANTA ANA, CA, 92702 <br />CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS AND REPRESENTATIVES ARE ADDITIONAL INSUREDS WITH <br />RESPECT TO GENERAL LIABILITY AND AUTO LIABILITY PER THE ATTACHED ENDORSEMENTS OR AS REQUIRED BY <br />WRITTEN CONTRACT. INSURANCE IS PRIMARY AND NON-CONTRIBUTORY. <br />ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED. <br />$150 ADDITIONAL PREMIUM <br />$4.50 SURPLUS LINES TAXES <br />$0.38 STAMPING FEE <br />154.88 TOTAL ADDITIONAL PREMIUM <br />REVIEWED & APPROVED <br />By Risk MANAGEMENT DIVISION <br />S 3 2020 <br />ANGIE ACEVEdo <br />03/11/2020 MN SS <br />IL 12 01 1185 Copyright, Insurance Services Office, Inc., 1983 Page 1 of 1 <br />Copyright, ISO Commercial Risk Services, Inc., 1983 <br />INSURED <br />C - Ea COS <br />