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DATE <br />SUPPLEMENT TO CERTIFICATE OF LIABILITY INS # 71107 JUN222022 <br />DESCRIPTION OF OPERATIONS, LOCATIONS, VEHICLES <br />The City of Santa Ana, Risk Management, it's officers, employees, agents, representatives, and volunteers are named as additional <br />Insured per form CG 20 12 12 19 on the GL policy. Primary and Non -Contributory wording applies. Waiver of Subrogation in Favor of <br />The City of Santa Ana per form CG 24 04 12 19, <br />Additional Insured, Primary & Non -Contributory Wording, and Waiver of Subrogation applies perform (60461AIS01, 600PNCV01, <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 UTS-410g (2-11). <br />Those usual to the Insured's operations. <br />Risk Mmaganent DMslan <br />E <br />tl' RE1/IELC/ED & APPRO <br />VED BY. <br />Risk Management Specialist <br />