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DATE <br />SUPPLEMENT TO CERTIFICATE OF LIABILITY INS # 76907 JUN252024 <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 38 12 19, CG 20 37 12-19, & CG 20 12 12-19 on the GL policy. Primary and Non -Contributory wording applies <br />per form CG 20 01 12 19. Waiver of Subrogation 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 forms (50461AIS01, 500PNCV01, <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 />Professional Liability - $2,000,000 per occurrence and $2,000,000 aggregate <br />$5,000,000 Excess to follow the GL, AUTO, WC per the attahced Dec Pages. <br />Those usual to the insured's operations. <br />Risk ManagmuxtDMsian <br />% REVIEWED & APPROVED BY. <br />® <br />Risk Management Specialist <br />