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POLICY NUMBER: 65 SBM AB6870 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED - PERSON -ORGANIZATION <br />CITY OF COSTA MESA <br />P 0 BOX 1200 <br />COSTA MESA CA 92728-8030 <br />LOC 001 BLDG 001 <br />CITY OF SANTA ANA <br />20 CIVIC CENTER PLZ <br />SANTA ANA CA 92701-4058 <br />Form IH 12 00 1185 T SEQ. NO. 002 <br />Process Date: 02/23/24 <br />Printed in U.S.A. Page 001 <br />Expiration Date: 11 <br />RIekM�ad.Dkielmt <br />R wewo & Aa m Sr. <br />®' Risk Management Speaalist <br />