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GENERAL CHANGE ENDORSEMENT <br />This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below: <br />Name of Insurance Company(ies) <br />Atain Specialty Insurance Company Atain Spec Insurance Company 100.0% GenLiab <br />Inception Date Expiration Date <br />11/9/2020 1/3.1/2021 <br />Endorsement Effective Policy Number Endorsement # <br />11/9/2020 CIP423084 1 <br />Named <br />SantaA �LNafrw q^n^' � W <br />City of Santa Ana �7i.W.'. " J' (1-C.ULYt'LL� <br />Countersigned By <br />(Authorized Representative) <br />IN CONSIDERATION OF THE PREMIUM PREVIOUSLY CHARGED, IT IS HEREBY UNDERSTOOD AND AGREED <br />THAT T1 TE POLICY IS AMENDED AS FOLLOWS: <br />THE SCHEDULE OF LOCATIONS IS HEREBY AMENDED TO READ FOR. NO FURTHER CHARGE: <br />LOCATION91: 1ST STREET/MAINST., SANTA ANA, CA 92701 <br />LOCATION#2: 3RD STREET/MAIN ST. SANT 1.4NA, CA 92701 <br />LOCATION#3: 4 TH STREE T LOCA TION#: /MAIN91'. SANTA ANA, CA92701 <br />LOCATION#4: 3RD STREET/ BROAD WAI, SANTA ANA, CA 92701 <br />LOCATION#5: 4THSTREET/ BROAD RIAY, SANTA ANA, CA92701 <br />LOCATION#6: 5THSTREET/BROADff�AY, SANTAANA, CA 92701 <br />LOCATION#7: 4THSTREET/BUSH, SANTAANA, CA 92701 <br />LOCA`1'ION#8: 1ST STREET/BRISTOL STREET, SANTA ANA, CA 92701 <br />LOCATION#9: 17THSTREET/BRISTOL STREET, SANTA ANA, CA 92701 <br />LOCATION#10: NIACARTFIUR BLVD/BRISTOL STREET, SANTA ANA, CA 92701 <br />LOCATION#11: NI41N STREET/MCFADDENAVE., SANTA ANA, CA 92701 <br />LOCATION912: HARBOR BLVD/MCFADDENAVE., SANTA ANA, CA 92701 <br />LOCATION913: GRAND/DYER, SANTA ANA, CA 92701 <br />LOCATIONW 4: 17TH STREET/CENTRE ON 17TH, SANTA ANA, CA 92701 <br />LOCATION41.5: 1STSTREET/DOYPNTO07NPLAZA, SANTA AAA, CA92701 <br />LOCATION#16: MAIN/WASHINGTON, SANTA ANA, CA 92701 <br />LOCATION#17: RAITTIAMCARTHUR BLVD., SANTA ANA, CA 92701 <br />LOCATION#18: GREENVILLL'/ALTON, SANTAANA, CA 92701 <br />LOCATION#19.•MAINS IMPT/WARNER AVE, 94NTA ANA. CA 92701 <br />LOCATION#20: FLOWERSTREETIBISHOP, SANTAANA, CA 92701 <br />All other terms and conditions remain unchanged. <br />knhom 12/4/2020 <br />.eye ,� RlekMansg�anenEDlWalon <br />+Y BaM-WED & APPROVED BY: <br />Rik Management Analyst <br />..._. <br />