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HEALTHCARE PROVIDERS <br />PROFESSIONAL LIABILITY INSURANCE ENDORSEMENT <br />Agreement to Provide Notice of Cancellation <br />In consideration of the premium paid, it is agreed that if the policy to which this endorsement is <br />attached is cancelled before the expiration date, we will endeavor to mail notice to the person or <br />entity named below. However, failure to mail such notice shall impose no obligation or liability of <br />any kind upon the company, its agents or representatives. <br />Person or Entity Name and Address: City of Santa Ana, its Officers Agents <br />and Employees <br />1907311-ME <br />•:: <br />Santa Ana, CA 92702 <br />This endorsement is a part of your policy and takes effect on the effective date of your policy, unless <br />another effective date is shown below. All other provisions of the policy remain unchanged. <br />Must a Completed <br />omp e Only When This Endorsernent Is Not Prepared w h the Policy <br />Or is Not to be Effective w#h the Policy <br />ENDT. NO. <br />POLICY NO. <br />ISSUED TO <br />ENDORSEMENT EFFECTIVE DATE <br />1 <br />298755008 <br />Wesley A Bosch <br />8/1/08 <br />G- 123828 -B (07/2001) <br />NW 3124/08 <br />