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POLICY NUMBER: 72 SBA UW5103 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />WAIVER OF SUBROGATION <br />a <br />r` <br />0 <br />U) <br />Form IH 12 00 11 85 T SEQ. NO. 003 Printed in U.S.A. Page 001 <br />Process Date: 03/23/10 Expiration Date: 03/01/11 <br />UW COPY <br />0 <br />M <br />0 <br />Ln <br />9 <br />N <br />r- <br />0 <br />O <br />O <br />r-1 <br />O <br />S <br />S <br />CITY OF SANTA ANA <br />PUBLIC WORKS AGENCY <br />SHERRY BARKLEY <br />20 CIVIC CENTER PLAZA <br />SANTA ANA, CA 92701 <br />Form IH 12 00 11 85 T SEQ. NO. 003 Printed in U.S.A. Page 001 <br />Process Date: 03/23/10 Expiration Date: 03/01/11 <br />UW COPY <br />