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HOLDER CODE CITSAN3 LAND800 PAGE 2 <br />NOTEPAD. INSURED'S NAME Landscape West Mgmt Svcs, Inc. OP ID: KC Date 03/24/2021 <br />ity of Santa Ana, it's Officers Employes Agents, Volunteers and <br />Apr@N <br />tatives are. included �s Additional insured inrespects to General <br />LLiabiy when requlr�d.bya writ N conG,tract per policy form HG 00 01 09 <br />16% Icoveraq@ Is, rim ry and on ontrlbutor, <br />Waiveubrogratglon Is Included per policy form �iC 99 04 1013. <br />cF Risk Manage mend Division <br />1'x REVIEWED & APPROVED BY: <br />V"° <br />--� Risk janagement Analyst <br />