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POLICY NUMBER: D94974112003 <br />BUSINESSOWNERS <br />BP 12 0108 10 <br />THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. <br />BUSINESSOWNERS POLICY CHANGES <br />THIS ENDORSEMENT FORMS A PART OF THE POLICY NUMBERED BELOW. <br />POLICY NUMBER POLICY CHANGES EFFECTIVE COMPANY <br />D94974112-003 05-15-2021 ACE Fire Underwriters Insurance <br />Company <br />NAMED INSURED AUTHORIZED REPRESENTATIVE <br />.Prime Government Soluti6n. s Inc Internal Users <br />CHANGES <br />Effective 05-15-2021, added Waiver of Subrogation and Primary/Non Contributory for: The City of Santa Ana <br />POLICY AMOUNT AND PREMIUM ADJUSTMENT <br />Limits Of <br />Insurance <br />Premiums <br />Add'I Premium <br />Return Premium <br />Coverage <br />Description <br />Previous Limit <br />Of Insurance <br />New Limit <br />Of Insurance <br />Previous <br />Premium <br />New <br />Premium <br />OPTIONAL COVERAGES <br />The following optional coverages are added under this policy <br />when designated by an "X" in the box(es) shown below. <br />Add'I Premium <br />Return Premium <br />Limits Of Insurance <br />Outdoor Signs <br />Location#1 <br />$ <br />$ <br />Outdoor Signs <br />Location#2 <br />$ <br />$ <br />Burglary and Robbery <br />(Named Peril Endorsement only) <br />Or <br />Money and Securities <br />$ Inside the Premises <br />$ Outside the Premises <br />$ Inside the Premises <br />$ Outside the Premises <br />$ <br />$ <br />Employee Dishonesty. <br />$ each occurrence <br />$ <br />E ui ment Breakdown 1 <br />$ <br />$ <br />BP 12 01 08 10 C Insurance Services Office, Inc., 2009 <br />Ride Management Division <br />REVIEWED & APPROVED BY. - <br />Risk Management Analyst <br />