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C S1'03/21/11'PAC5154680-05 000146016 'D/B <br />ORIG IMAGE COPY <br />AMENDED <br />03/21/2011 0694804 <br />GREAT AMERICAN <br />AILLLIP1IdC&21NS '010/07 <br />07/20/2010 To <br />Time at the address <br />Administrative Offices <br />=Administrative <br />Street <br />P o l i c y No. <br />PAC 51 5-46-80 - 05 <br />GRE -"',AMERICAN. <br />Cincinnati, OH 45202 <br />Effective Date <br />of Change 03/21/201 1 <br />insuxnnce G.- <br />513.369.5000 ph <br />BUSINESSPRO <br />POLICY CHANGES <br />NAMED INSURED ORANGE COUNTY CONSERVATION <br />CORPS <br />AND ADDRESS: 1853 N. RAYMOND AVE <br />ANAHEIM, CA 92801 <br />THIS ENDORSEMENT AGENT'S NAME AND ADDRESS: <br />CHANGES THE POLICY. CHAPMAN & ASSOCIATES, INC. <br />PLEASE READ IT PO BOX 5455 <br />CAREFULLY. PASADENA, CA 91117 0455 <br />n s u r a n c e is afforded by the Company named below, a Capital Stock Corporation: <br />GREAT AMERICAN ALLIANCE INSURANCE COMPANY <br />IT IS HEREBY UNDERSTOOD AND AGREED THAT THE POLICY IS AMENDED AS FOLLOWS <br />ADDING FORM CG2026-ADDITIONAL INSURED -DESIGNATED PERSON OR ORGANIZATION <br />TO THE POLICY AS RESPECTS TO: <br />THE CITY OF SANTA ANA AND THEIR <br />RESPECTIVE OFFICERS, EMPLOYEES, AGENTS, <br />VOLUNTEERS AND REPRESENTATIVES <br />THE CITY OF SANTA ANA <br />20 CIVIC CENTER PLAZA <br />SANTA ANA, CA 927001 <br />NDORSEMENT # 6 <br />ANY AMENDED FORMS ATTACHED TO THIS CHANGE DISPLAY PREMIUMS FOR A FULL <br />POLICY TERM. <br />Forms and Endorsement Activity <br />CG2026 07/04 ADDL INS -DESIGNATED PERSON/ORGANI ADDED <br />Countersigned By <br />Date <br />IL 70 02 10107 <br />Authorized Signature <br />(Page 1 of 1 ) TOADMMK <br />POLICY <br />12 01 A. <br />PERIOD: From <br />M. Standard <br />07/20/2010 To <br />Time at the address <br />07/20/2011 <br />of the Named Insured <br />IT IS HEREBY UNDERSTOOD AND AGREED THAT THE POLICY IS AMENDED AS FOLLOWS <br />ADDING FORM CG2026-ADDITIONAL INSURED -DESIGNATED PERSON OR ORGANIZATION <br />TO THE POLICY AS RESPECTS TO: <br />THE CITY OF SANTA ANA AND THEIR <br />RESPECTIVE OFFICERS, EMPLOYEES, AGENTS, <br />VOLUNTEERS AND REPRESENTATIVES <br />THE CITY OF SANTA ANA <br />20 CIVIC CENTER PLAZA <br />SANTA ANA, CA 927001 <br />NDORSEMENT # 6 <br />ANY AMENDED FORMS ATTACHED TO THIS CHANGE DISPLAY PREMIUMS FOR A FULL <br />POLICY TERM. <br />Forms and Endorsement Activity <br />CG2026 07/04 ADDL INS -DESIGNATED PERSON/ORGANI ADDED <br />Countersigned By <br />Date <br />IL 70 02 10107 <br />Authorized Signature <br />(Page 1 of 1 ) TOADMMK <br />