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GENERAL CHANGE ENDORSEMENT
<br />Lnis enu.oraement ananges ins policy elEeeLIVe on one inception Hato of the policy unless another data is indicated below:
<br />Nance of inawanco Company(ios)
<br />Atain Specialty Insurance Company Atain Spec Insurance Company 100.0% GenLiab
<br />Inooption Date
<br />11/9/2020
<br />Expiration Date
<br />1/31/2021
<br />Endorsement Effective Polioy Number Endorsement #
<br />1 V9/2020 CIP423084 I
<br />Named Insured
<br />City of Santa Ana
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<br />Countersigned By
<br />(Authorized Reprosontativo)
<br />IN CONSIDERATION OF TIM PREMiOMPREVIOU9LY CHARGED, ITI,S HEREBY UNDERSTOOD AND AGIZE1,3D
<br />THAT THE POLICY IS AMENDED AS FOLLOWS:
<br />TIM SCHEDULE 010 ;LOCATIONS IS HEREBY AMMi I D TO READ FOR NO FUR.TFIER CHARGE:
<br />LOCATI001: I ST STIMT/MAINST., SANTA ANA, CA 92701
<br />LOCATION#2: 312D SP1i1Er1MA1N ST SANTA ANA, CA 92701
<br />LOCA`I'ION#3r 4TH S71ils'ET LOCATION#: /MAIN SP SANTA AMA, CA 92701
<br />LOCATION#4. 3RD 8TREE77BR0ADWAY, SANTAANA, CA 92701
<br />LOCATION#5: 4THS'nW.ET/BROADWAY, SANTAANA, CA 92701
<br />LOCATION#6: S'THST1iEET/BROADWAP, SANTA ANA, CA92701
<br />LOCATIONM 4TTI STREET/BUSH, SANTAANA, CA 92701
<br />LOCATION#8: 115T STREET/BRISTOLMEE7, SAN7AANA, CA 92701
<br />LOCATION#9: 17TIiSTREET/BRISTOL STREET, SANTAANA, CA 92701
<br />LOCATTON#10: AMCARTHUR BLVD/BRISTOL S'7REET, SANTAANA, CA 92701
<br />LOCATION#II:MAINSTItEETIMCF'ADDENAVV,, SANTA AMA, CA 92701
<br />LOCATION#12: IiA BORBLVD/MCFADDLNAPK, SANTAANA, CA92701
<br />LOCATI0N#13: GRAMIDYM SANTA ANA, CA 92701
<br />LOCATION#14:17TH S7 MMYCLINTRE ON 17TH, SANTA ANA, CA 92701
<br />LOCATION05: ISI' STRC'E7%D091AITOWNPLAYA, SANI'AANA, CA 92701
<br />LOCATION#I6:IVIAIN/W4SHINGT0N, SANTAANA, CA 92701
<br />LOCATIONN7: BAIT TUACARTHUR BLVD., SAWA AMA, CA 92701
<br />LOCATION9.I8: GREENVILLT/ALTON, SANTA ANA, CA 92701
<br />LOCATION#19: A9AINMEET/ WARNERAI,E., SANTA ANA, CA 92701
<br />LOCIT7OM120: FLOWER STRls'ET/BISHQ, "IAANA, CA 92701
<br />All other terms and conditions remain amehanged.
<br />knhom 12/4/2020
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<br />Ii1slc M<7n�a�m�encAnalyst
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