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POLICY NUMBER: H-630-5A888588-TIA-21 <br />ISSUE DATE: 12-03-21 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />DESIGNATED PERSON OR <br />CANCELLATION PROVIDED <br />This endorsement modifies insurance provided under the following: <br />ALL COVERAGE PARTS INCLUDED IN THIS POLICY <br />CANCELLATION: <br />PERSON OR <br />ORGANIZATION: <br />CITY OF SANTA ANA <br />RISK bLUAGEMOTT DIVISION <br />ADDRESS: <br />20 CIVIC CENTER PLAZA <br />SCHEDULE <br />Number of Days Notice: 30 <br />PROVISIONS <br />If we cancel this policy for any legally permitted reason other than nonpayment of premium, and a number of days <br />is shown for Cancellation in the Schedule above, we will mail notice of cancellation to the person or organization <br />shown in such Schedule. We will mail such notice to the address shown in the Schedule above at least the <br />number of days shown for Cancellation in such Schedule before the effective date of cancellation. <br />IL T4 05 05 14 (D 2019 The Travelers Indemnity company_ All rights reserved. <br />cF RAMwagementDMsian <br />ke/ \° REVIEWED & APPROVED BY: <br />— --� Rt janagement Analyst <br />