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<br />POLICY CHANGE DOCUMENT <br /> <br />POLICY NO.: PHPK321591 <br /> <br />Philadelphia Indemnity Insurance Companyl16012 Sherman Parent Prince & Fleming Insuran <br /> <br />NAMED INSURED East L.A. Classic Theatre Corp <br /> <br />MAILING ADDRESS 2168 S Atlantic Blvd <br />Monterey Park, CA 91754-6839 <br /> <br />POLICY PERIOD: FROM 07/31/2008 TO 07/31/2009 at <br />12:01 A.M. Standard Time at your mailing address shown above. <br /> <br />CHANGE EFFECTIVE 09/23/2008 <br /> <br />CHANGE # <br /> <br />2 <br /> <br />DESCRIPTION <br /> <br />In consideration of the premium renected, the policy is amended as indicated below: <br /> <br />The following Additional Insured is added to the policy per the attached <br />CG2026-Additlonal Insured-Designated Person or Organization in regards to <br />theatre classes for the Parks & Recreations from 9/23/2008 to 3/31/2009 <br /> <br />City of Santa Ana <br />Attn: Parks & Recreation <br />20 Civic Center Plz <br />Santa Ana, CA 92701 <br /> <br />Path ID 3158005, 3187831 <br /> <br />Total Annual <br />Additional/Return Premium $ <br /> <br />0.00 <br />NO CHANGE <br /> <br />Total Prorate <br />Additional/Return Premium $ <br /> <br />0.00 <br />NO CHANGE <br /> <br />COUNTERSIGNED <br /> <br />BY <br /> <br />(Date) <br /> <br />(Authorized Representative) <br /> <br />Insurance Policy <br /> <br />Page 1 of 1 <br />