Laserfiche WebLink
M <br />HEALTHCARE PROVIDERS <br />PROFESSIONAL LIABILITY INSURANCE ENDORSEMENT <br />Agreement to Provide Notice of Cancellation <br />In consideration of the premium paid, it is agreed that if the policy to which this endorsement is <br />attached is cancelled before the expiration date, we will endeavor to mail notice to the person or <br />entity named below. However, failure to mail such notice shall impose no obligation or liability of <br />any kind upon the company, its agents or representatives. <br />Person or Entity Name and Address: City of Santa Ana, it Ofhcers,Agents and <br />Employees <br />Po. Box 1988 <br />Santa Ana CA 92702 <br />This endorsement is a part of your policy and takes effect on the effective date of your policy, unless <br />another effective date is shown below. All other provisions of the policy remain unchanged. <br />Must Be Completed - Complete n en This Endorsement Is Prepared w the o cy <br />Or Is Not to be I;fred/Ve w#h the Policy <br />ENDT. NO. POLICYNO. ISSUED TO ENDORSEMENT EFFECTIVE DATE <br />1 0298755008 Wesley A Bosch 08101/2009 <br />G-123828-B (0712001) <br />CV 07130/2009 <br />APPROVED AS TO k'tr't <br />LISA E. STORCK W <br />Assistant City Attorney