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PINNACOL 7501 1=,Lowry Blvd. <br /> Denver, CO 80230.7006 <br /> ASSURANCE 303.361,4000 J 800.873.7242 <br /> Pinnacol.com <br /> NGCI#:WC000313 <br /> Policy#: 516892 <br /> Bonded Collection Service Inc Crest Insurance Group of Colorado, <br /> P O Box 1317 2000 S. Colorado Blvd, Suite 11100 <br /> Longmont, CO 80502 Denver, CO 80222 <br /> (720)667-1850 <br /> ENDORSEMENT: Waiver Of Subrogation <br /> We have.the right to recover our payments from anyone liable for an Injury covered by this policy. We will not <br /> enforce our right against the person or organization named in the Schedule. (This agreement applies only to the <br /> extent that you perform work under a written contract that requires you to obtain this agreement from us.) <br /> This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. <br /> SCHEDULE <br /> City of Santa Ana <br /> 20 Civic Center Plaza <br /> PO Box 1988 <br /> Santa Ana, CA 92702 <br /> Effective Date:July 10, 2025 <br /> Pinnacol Assurance has Issued this endorsement July 10, 2025 <br /> 7501 E.Lowry Blvd Denver,Cp 80230.7006 <br /> Page 1 of 3 P sherrf.schwelger@bcservlce.aom- 07/1 WgD25 15:00:29 516W 85405352 UW 137 <br />