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<br />AUG.2l'2D00 09:59 7142550872 <br /> <br />. NIl <br /> <br />w^:-:/t;cp <br /> <br />.. <br /> <br />-- <br /> <br />~~ditioDallnsured I HCF-X91 <br />EntIty Endorsement <br /> <br />#531~ P.002/002 <br /> <br />American H.e:lfrhcare Indemnity <br />CO.......NY <br /> <br />Amen~rng Polrey Number; <br /> <br />HCF0000155 <br /> <br />Endor6~~nr. Humber: <br /> <br />6 <br /> <br />N,.m~d In&lJred: <br /> <br />EM T [I) INGER "'(0 I CAL CENTroR <br /> <br />EffOCt.1 ve Date of EndorG.ement; 1/01/2000 12:01 A.M, STi\nd,~rlf ilm,c <br /> <br />Date Issued: 8/08/2000 <br /> <br />(xpl~~t'on D.tg or Endorsament: 1/01/2001 <br /> <br />Addftfonel Premlu~: <br /> <br />$.00 <br /> <br />Rstl.lrn Promlum: <br /> <br />$.00 <br /> <br />In consideration of the premium charw:d, ic i. bereby understood and agreed tbat the obo,,", captioned <br />poli.cy (the 'Policy") i. amended .s follows: <br /> <br />The term Insured In t~e PolIcy sholl also inClUde ftnd 016Q mean the entfty <br />~e&l~n~tp.d Derow; <br /> <br />lhe City o~ Sent. Ana, 20 Civic Centor Plez8, S~nt.a Ana, CA 92101 <br />Its Qfrlc~r&. employees, 8gent&, VOJunteer~ BOd represent8tlve6 <br /> <br />l "00& I llnatet,l Ent' tylt, <br /> <br />T~e DeSignateD EntIty understond6~ .ek~a~IQ49~s and D9r~~$ that if the <br />PolICy termInates Qr 13 cenCQ'ed for .ny r9Ason, t~ls cndor&ement~ and alt <br />Coverages srrorded hereunder, shall be deemed DYtom.tJcD'J~ tarmJnated, <br />wl~hout fUrtnor B~knQ~Iedgm~~t by the Company, as or the date of <br />term(natlon or Ca"ce"~tlun or $'~h POlicy. <br /> <br />It Is rurth~r understood and agreed <br />rIght to purchase Qr Qthorwfse <br />endorseMents pur&lJant 'to SeetfQn <br />nonr9ne~al Qr other terminat.lon Qf <br /> <br />tha~ the Oe~(g"Qted Enttt~ haG no <br />aCq~rrQ a reporting endorsement or <br />8 of the Poffr.~ upon ClnQofl3tiQn~ <br />thf6 ondorsement. <br /> <br />All otb~r te!'lm and condition. rem.;n unchonged. <br /> <br />Amt"ti~.n He:\',I~I'W;are Indflmnily Company <br /> <br />By <br /> <br />lQlf'n~ '\ . ~j,,-- <br /> <br />rn:5Ide,.,r. <br /> <br />HCF-X91 <br /> <br />1,8198) <br /> <br />APPROVEp AS <br />f <br />! <br /> <br />TO 1.\_'i....Jyj <br /> <br /> <br />Michael Vigliott <br />Deputy City /\t~()rllC\ <br /> <br />