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GENERAL CHANGE ENDORSEMENT <br />This endorsement changes the policy effective on the inception elate 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 1/31/2021 <br />Endorsement Effective Policy Number Endorsement # <br />11/9/2020 1 CIP423084 1 <br />Named Santa �s-'-'r`e � � <br />City of Santa Ana .1LGf1"` " J' <br />Countersigned By <br />(Authorized Representative) <br />IN CONSIDERATION OF TFTF PREMIUM PREVIOUSLY CHARGED, IT IS HEREBY UNDERSTOOD AND AGREED <br />THAT THE POLICY IS AMENDED AS FOLLOWS: <br />THE SCI3CDULE OF LOCATIONS IS HEREBY AMENDED TO READ I OR. NO FURTHER CHARGE: <br />LOCATION01: 1ST STREET/MAINS'T., SANTAANA, CA 92701 <br />LOCATION#2: 31ZD STREETIAMINSI'. SANTAANA, CA 92701 <br />LOCATION#3: 4'1'1-1 STREET LOCATION#: I&MIN ST. SANTA ANA, CA 92701 <br />LOCATIONW: 3RD STREET/BROAD 6VAY, SANTA ANA, CA 92701 <br />LOCATION0: 4THSTREET/BROADPVAl' SANTAANA, CA 92701 <br />LOCATlONtt6: SI'1ISTREETIBROADNAI; SANTAANA, CA 92701 <br />LOCATION#7: 4THSTREET/BUSH, SANTAANA, CA 92701 <br />LOCATION08: 1ST STREETI BRISTOL STREET, SANTA ANA, CA 92701 <br />LOCATION99: 17TH STREET/BRISTOL STREET, SANTA ANA, CA 92701 <br />LOCATION410: MACARTHUR BLVD/BRISTOL STREET, SANTAANA, CA 92701 <br />LOCATION#11: MAINSIREET/AdCFADDENAVE., SANTA ANA, CA 92701 <br />LOCATION#12: HARBOR BLVDMCFADDENAVE., SANTA ANA, CA 92701 <br />LOCATION#13: GRAND/DYER, SANTA ANA, CA 92701 <br />LOCATION#14: 17TH STREET/CENTRE ON 17TH, LAATTA ANA, CA 92701 <br />LOCATION#15: ISTSTREETIDOYVNTOWNPLAZA, SANTAANA, CA 92701 <br />LOCATION916: MAIN/NfASHINGTON, SANTA ANA, CA 92701 <br />LOCATION#17: RA17TIMACARTHUR BLVD., SANTAANA, CA 92701 <br />LOCATION#18: GREENVILLE/ALTON, SANTA ANA, CA 92701 <br />LOCATI01019: MAIN STREET/ PVAPNBR ATIE, SANTA ANA, CA 92701 <br />LOCATION#20: FLOPVER STREETIBISHOP, SANTAANA, CA 92701 <br />Al] other terms and conditions remain unchanged. <br />knhom 12/4/2020 <br />A"ManarnentDwislmi <br />hkp pp <br />[REmFWED&APPPR�OVED BY: <br />Risk Management Arialys[ <br />