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7mEVhStreet <br />Policy <br />No. <br />PAC 515-46-80 OS <br />GuFATA....... ... .._._.1._.1 ... eesi..-...,_ n_._ _. nI__....... . <br />C ' S1 '06/08/11'PAC5154680-05 000146016 'D/B ORIG IMAGE COPY <br />AMENDED 06/07/2011 06948 04 GREAT AMER ICAN A I'LLI IB r+ C&2 INS CO10/07 <br /> Administrative Offices <br />301 E4th Street <br />Policy <br />No. <br />PAC 515-46-80 05 <br />G R E A T , 4 M E R I C A N Cincinnati, Ohio 45202-4201 E f f e c t i v e D a t e of Change 0 6/ 0 7/ 2 0 1 1 <br />INSURANCE GROUP te1: 5133695000 <br />BUSINESSPRO 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 />nsurance is afforded by the Company named below, a Capital Stock Corporation <br />GREAT AMERICAN ALLIANCE INSURANCE COMPANY <br />POLICY PERIOD: From 07/20/2010 To 07/20/2011 <br />12:01 A.M. Standard Time at the address of the Named Insured <br />IT IS HEREBY UNDERSTOOD AND AGREED THAT THE POLICY IS AMENDED AS FOLLOWS: <br />\DDING FORM CG2026-ADDITIONAL INSURED-DESIGNATED PERSON OR ORGANIZATION <br />rO THE POLICY AS RESPECTS TO <br />THE CITY OF SANTA ANA, <br />ITS OFFICERS, EMPLOYEES, <br />AGENTS, VOLUNTEERS AND <br />REPRESENTATIVES <br />THE CITY OF SANTA ANA <br />20 CIVIC CENTER PLAZA <br />SANTA ANA, CA 92702 <br />DORSEMENT # 8 <br />g g TO vow <br />?pROVE ? <br />LISA E, g'fORCK <br />City <br />Assistant Attorney <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 Authorized Signature <br />IL 70 02 10/07 (Page 1 of 1 ) TOADMMK <br />F 8972D (7/2011)