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POLICY NUMBER: 57 SEA E23 452 <br />F11 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED - PERSON - ORGANIZATION <br />m CITY OF SANTA ANA, IT'S OFFICER'S, AGENTS AND EMPLOYEE'S <br />20 CIVIC CENTER PLAZA <br />° SANTA ANA, CA 92702 <br />m <br />0 <br />N <br />�1 <br />[sM] <br />W <br />r <br />N <br />O <br />O <br />Q <br />N <br />k <br />.�.ar <br />�+n <br />h <br />Applio'VED &g, TO FORM <br />,Assistant City <br />Form IH 12 00 1186 TSEQ. NO. 004 Printed In U.SA. Page 001 $ <br />Process Date: 05/07/13 Expiration Date: 01/09114 <br />INSURED COPY <br />