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<br />. <br /> <br />Policy Change 00 0 1 <br />Number <br /> <br />GU 269 <br />(11-85) <br /> <br />THE ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> <br />IL12011185 <br /> <br />POLICY CHANGES <br /> <br />POLICY NO. <br /> <br />POLICY CHANGES <br />EFFECTIVE <br /> <br />GLP0000568996402 <br /> <br />02/20/07 <br /> <br />COMPANY <br />GREAT AMERICAN ASSURANCE <br />COMPANY <br /> <br />NAMED INSURED <br /> <br />AUTHORIZED REPRESENTATIVE <br /> <br />LADIES PROFESSIONAL GOLF ASSOCIATION <br /> <br />K&K INSURANCE AGENCY,INC. <br /> <br />COVERAGE PARTS AFFECTED <br /> <br />PAGE 01 OF 01 <br /> <br />COMMERCIAL GENERAL LIABILITY <br /> <br />CHANGES <br /> <br />THE POLICY IS AMENDED AS FOLLOWS: <br /> <br />ADD ADDITIONAL INSURED: CITY OF SANTA ANA, ITS OFFICERS, AGENTS, <br />EMPLOYEES AND REPRESENTATIVES <br />FORM GAC 3580CG IS BEING ADDED TO THE POLICY WITH RESPECTS TO THE <br />ABOVE MENTIONED ADDITIONAL INSURED. <br /> <br />THE INSURED <br />IS IMPAIRED <br />ANY PREMIUM <br /> <br />HEREBY ACKNOWLEDGES THAT THEIR CANCELLATION OF THE POLICY <br />DUE TO THE ATTACHED GAC3580CG AND WILL BE RESPONSIBLE FOR <br />PAYMENT DUE DURING THE NOTIFICATION PERIOD. <br /> <br />INSURED NAME <br /> <br />DATE <br /> <br />~"_:~:;;;~~~ -:> ~ <br />, ~ <br /> <br />Copyright Insurance Services Office, Inc., 1983 <br />Copyright. ISO Commercial Risk Sen1ces, Inc. 1983 <br /> <br /> <br />JA 02/20/07 <br /> <br />