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Starr Indemnity & Liability Company <br />Dallas, TX 1-866-519-2522 <br />AMENDMENT - NOTICE OF CANCELLATION FOR <br />SCHEDULED THIRD PARTIES <br />Policy Number: 1000198198211 Effective Date: July 1, 2021 at 12:01 A.M. <br />Named Insured: West Coast Arborists, Inc. <br />This endorsement modifies the insurance coverage form(s) listed below that have been purchased by you and <br />evidenced as such on the Declarations page. Please read the endorsement and respective policy(ies) carefully. <br />Auto Dealers Coverage Form, Business Auto Coverage Form, Business Auto Physical Damage <br />Coverage Form, Commercial General Liability Coverage Form, Contractor's Pollution Liability <br />Coverage Form, Electronic Data Liability Coverage Form, Excess Liability Policy Form, Garage <br />Coverage Form, Liquor Liability Coverage Form, Motor Carrier Coverage Form, Owners And <br />Contractors Protective Liability Coverage Form -Coverage For Operations Of Designated Contractor, <br />Pollution Liability Coverage Form Designated Sites, Products/Completed Operations Liability <br />Coverage Form, Product Withdrawal Coverage Form, Professional Liability Coverage Form, Railroad <br />Protective Liability Coverage Form, Site Pollution Liability Coverage Form, Special Protective And <br />Highway Liability Policy -New York Department Of Transportation, Truckers Coverage Form, <br />Underground Storage Tank Policy Designated Tanks. <br />It is agreed that in the event the Insurer cancels the policy for any reason other than non-payment of premium, the <br />Insurer will give notice of cancellation to the following certificate holder(s): <br />SCHEDULE <br />(Certificate Holder, contact name, address) <br />City of Santa Ana Francine Villareal RMDCa.Santa-Ana.oro <br />Risk Management Division <br />20 Civic Center Plaza, 41h Floor <br />Santa Ana, CA 92701 <br />Thirty (30) Day's Notice of Cancellation and 10 Days Non -Payment <br />The Insurer will endeavor to provide notice of cancellation to the certificate holder(s) listed in the Schedule by email. <br />The Insurer agrees to provide such notice of cancellation at a rate of $10 per scheduled certificate holder up to a <br />maximum of $25,000 for this policy. <br />This notification of a pending cancellation of coverage is intended as a courtesy only. The Insurer's failure to provide <br />such notice will neither extend the policy cancellation nor negate cancellation of the policy; nor will this failure result <br />in obligation or liability of any kind upon the Insurer, its agents or representatives. <br />This endorsement does not affect, in any way, coverage provided under this policy, the cancellation of this policy or <br />the effective date of cancellation. <br />All other terms and conditions of this Policy remain unchanged. <br />Risk Mwrgrn nWivislan <br />SIIL-101 (10114) RE\n &APPRovmft <br />Copyright © Starr Indemnity & Liability Company. All rights reserved. <br />Includes copyrighted material of ISO Properties, Inc., used with its permission. v <br />�� Risk Management Analyst <br />