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Policy Change <br />Number <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />POLICY CHANGES <br />THIS ENDORSEMENT FORMS A PART OF THE POLICY NUMBERED BELOW: <br />POLICY NUMBER <br />POLICY CHANGES <br />COMPANY <br />EFFECTIVE <br />8502SS307001 - 3 <br />12-14-2010 <br />Markel Insurance Company <br />NAMED INSURED <br />AUTHORIZED REPRESENTATIVE <br />Delhi Community Cantor <br />Bruce A. Kay <br />COV RAGE PARTS AFFECTED <br />Commercial Auto - Standard Package <br />Commercial Fire Package <br />Commercial Inland Marine Package__ <br />General Liability Package <br />CHANGES <br />In consideration of the premium charged, It is hereby agreed that the following <br />wording is added with respects to the Additional Insured - Designated Person or <br />Organization Endorsement (C(32026) Issued to City of Santa Ana, Santa Ana WORK Center: <br />This insurance is primary and non-contributory. <br />All other terms and conditions remain the same. <br />D g,S 'TO FORM <br />/ 'VC c`e`) <br />`tam C�tY AttoC <br />Asses fI <br />The above alnendment(s) result In a change in premium as follows: <br />Q <br />NO CHANGESTO <br />_ <br />BE ADJUSTED <br />AT AUDIT <br />ADDITIONAL <br />PREMIUM <br />RETURN PREMIUM <br />$ 0.00 <br />$ <br />42 <br />Bruce A. Kay w� �• <br />Authorized Representative SiFnature <br />MAN IL 12 01 11 65 Copyright, ISO Commercial Risk Services, Inc., 1983 02-10-2011 <br />