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POLICY NUMBER: VHPUD-T <br /> 1L 00 17 1198 <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> NOTICE OF CANCELLATION TO OTHERS <br /> This endorsement modifies the coverage provided under the following: <br /> COMMERCIAL GENERAL LIABILITY COVERAGE <br /> With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless <br /> modified by the endorsement. <br /> SCHEDULE <br /> Name Of Person(s) <br /> Or Organization(s) Number of Days Notice <br /> City of Santa Ana 30 <br /> Risk Management Division <br /> 20 Civic Center Plaza <br /> Santa Ana, CA 92701 <br /> information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br /> The following additional condition is added: c. Will not extend the cancellation effective <br /> A. Notice of Cancellation to Others date nor impact or negate any cancellation <br /> 1. If we send notice of cancellation to the Named of the policy; <br /> Insured shown in the declarations,for a reason 3. We are not obligated to notify the person(s) or <br /> other than nonpayment of premium, we will organization(s) shown in the schedule of the <br /> provide notice of such cancellation to the expiration, renewal on different terms or <br /> person(s) or organization(s) listed in the nonrenewal of the policy to which this <br /> schedule of this endorsement(the schedule); endorsement is attached; and <br /> 2. This notice: 4. The provisions of this endorsement do not <br /> a. Will be provided not less than the number <br /> entitle the person(s) or organization(s) listed in <br /> the schedule to any benefits, rights nor <br /> of days shown in the schedule prior to the protections not already provided for under the <br /> cancellation effective date indicated in the policy. <br /> schedule; <br /> All other terms and conditions of the policy remain <br /> b. If mailed,will be sent to the mailing address unchanged. <br /> known to us at that time, with proof of <br /> mailing constituting sufficient proof of <br /> notice; and <br /> IL 00 17 1198 Page 1 of 1 <br /> VHPUD-T 2pZg <br /> Scottsdale Insurance Company <br /> APPROVED <br /> BY <br /> Laisa AWera at 2:29 pm,Jan 69,2M <br />