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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 <br />Atain Spec Insurance Company 100.0% GenLiab <br />Inception Date Expiration Date <br />11/9/2020 1/31/2021 <br />Endorsement Effective <br />Policy Number Endorsement # <br />11/9/2020 <br />CIP423084 1 <br />Named Insured <br />City of Santa Ana <br />CC//���,.,� �p�� <br />.�"46 weV a� <br />Countersigned By <br />(Authorized Representative) <br />IN CONSIDERATION OF THE PREMIUM PREVIOUSLY CHARGED, IT IS HEREBY UNDERSTOOD AND AGREED <br />THAT TIE POLICY IS AMENDED AS FOLLOWS: <br />TFM SCHEDULE OF LOCATIONS IS HEREBY AMENDED TO READ FOR NO FURTHER CHARGE; <br />LOCA7 ION#1: 1ST STREETIMAINST., SANTA ANA, CA 92701 <br />LOCATION42::)RD STREET/MAINST. SANTA ANA, CA 92701 <br />LOCATIONW: 41H STREET .LOCATION#: /MAIN ST. SANTA ANA, CA 92701 <br />LOCATIONW:.3RD STREETIBROADWAP, SANTAANA, CA ,92701 <br />LOCATION#S: 4T.HSTREETIBROADWAY, SANTA AArA CA 92701 <br />LOCATION#6: 5THSTREETIBROADWAY, SAN!AANA, CA 92701 <br />LOCATION#7: 4TH STREETI B USH,, SANTA ANA, CA 92701 <br />LOCATION48: IST STREETIBRISTOL STREET, SANTAANA, CA 92701 <br />LOCATION#9: 17T1-I STREETI BRISI'OI, STREET, SANTA ANA, CA 92701 <br />LOCATION410: MACARTHUR BLVD/BRISTOL STREET, SANTAANA, CA 92701 <br />LOCATION#II: MAIN STREET/MCFADDENAVE, SANT,4 ANA, CA 92701 <br />LOCATI0012: HARBOR BLVDIUCRADDENAVE., SANTA ANA, CA92701 <br />LOCATION#13: GRAND/DPER, SANTA ANA, CA 92701 <br />LOCATION04: 17TH STREET/CENTRE ON 1717-1, SANTA ANA, CA 92701 <br />LOCATIONW: 1ST STREET/DOPTNTOWN PLAZA, SANTA VA, CA 92701 <br />LOCATION016: MARVIWASHINGTON, SANTA ANA, CA 92701 <br />LOCATI0N#17: RA1T7yMACARTHUR BLVD., SANTA ANA, CA 92701 <br />LOCATION918: GREENVILLEIALTON, SANTA ANA, CA 92701 <br />LOCATION#19: MAIN bTRN_ET/ RARNER. AVE, SANTA ANA. CA 92701 <br />LOCATION920: FLOWER STREET/BISHOP, SANTAANA, CA 92701 <br />All other terms and conditions remain unchanged. <br />knhom 12/4/2020 <br />»a,;a Risk Mamvxammti tvwtm— <br />q _h RwEWEo& APPPROVAED AY. <br />�^^ Rtskhe�n�gementAnaryst ' <br />