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Issuing Company: Great Divide Insurance Company <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />Policy No.: CNA 7514665 - 11 <br />POLICY CHANGES <br />Policy Change Number: 1 <br />IL 12 01 11 85 <br />NAMED INSURED AND ADDRESS AGENCY NAME AND ADDRESS 10030 <br />Dynamic Video Communications LLC (800) 228-7975 <br />30211 Avenida de las Banderas, Ste 200 Brown & Brown of CA Inc <br />Rancho Santa Margarita, CA 92688 2401 E. Katella Ave, Suite 550 <br />Anaheim. CA 92806 <br />POLICY CHANGES EFFECTIVE Jan 25, 2022 <br />Amount Due For Endorsement <br />ADJUSTED Annual Premium/Fees <br />COVERAGE PARTS AFFECTED <br />(X) Additional Interested Parties <br />Coverage <br />Commercial Auto <br />Commercial Auto Total <br />General Liability <br />General Liability Total <br />Total <br />$ 2,719.00 <br />Additional / Return <br />$ .00 <br />$ .00 <br />$ .00 <br />$ .00 <br />$ .00 <br />Changes <br />Endorsement #1 <br />It is hereby agreed and understood that Additional Insured and Waiver of Subrogation is amended to read per <br />forms CG 20 26 and CG 24 04 attached: <br />City of Santa Ana 20 Civic Center Plaza (M-30) <br />P.O. Box 1988 <br />Santa Ana CA 92702-1988 <br />IL 12 01 11 85 Copyright, Insurance Services Office, Inc., 1983 <br />Copyright, ISO Commercial Risk Services, Inc., 1983 <br />ew cF RAMwagementDMsian <br />Jy/\'x REVIEWED & APPROVED BY.- <br />V"° <br />--� Risk janagement Analyst <br />