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POLICY NUMBER: 72 SSA IT9447 <br />ADDITIONAL INSURED - PERSON-ORGANIZATIOM <br />CITY OF SANTA ANA <br />PUBLIC WORKS AGENCY <br />20 CIVIC CENTER PLAZA <br />SANTA ANA CA 92702 <br />Form IH 12 00 11 85 T SEQ. NO. 001 Printed in U.S.A. Page 002 (CONTINUED ON NEXT PACE) <br />Process Date: 06/02/16 Expiration Date: 08/19/17 <br />