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SUPPLEMENT TO CERTIFICATE OF LIABILITY INS #70212 FBA 7E2022 <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS <br />The City of Santa Ana, Risk Management, it's officers, employees, agents, representatives, and volunteers are named as <br />additional Insured per form CG 2012 12 19 on the GL policy. Primary and Non -Contributory wording applies. Waiver of Subrogation <br />In Favor of The City of Santa Ana per form CG 24 04 12 19. <br />Additional Insured, Primary & Non -Contributory Wording, and Waiver of Subrogation applies per form (50461AIS01, 800PNCV01, <br />50461SWF01) on the Auto policy. <br />Waiver of Subrogation on the WC Policy per form #10217 <br />Certificate of Insurance shall provide thirty (30) day prior written notice of cancellation per attached form UTS4109 (2.11). <br />Those usual to the Insured's operations. <br />Cedi <br />e <br />Rlak Tf arugm,enf D[Wston <br />Re EwED&APPRwm BY. <br />�'. <br />A-�u Acevdv <br />® <br />Risk Management Specialist <br />