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Courtesy Notice of Cancellation for Other Than <br />Nonpayment of Premium to Designated Entities - 145977 01 11 <br />Policy Amendment <br />Schedule <br />Name and Address of Person(s) or Organizations Number of Days Notice if other than 10 days: <br />The City of Santa Ana, it's officers, employees, agents, and representative <br />24 Civic Center Plaza, <br />Santa Ana, California 92701 <br />Information required to complete this Schedule, if not shown above, will be shown in the Doclarations. <br />This policy is amended as follows: <br />A. If We cancel this policy prior to expiration for any reason other than non payment of premium or <br />at Your request, and we have been notified that You are required under a current contractual <br />obligation to notify a certificate of Insurance holder or holders when this policy Is canceled, then <br />We will endeavor to mail or deliver a copy of such written notice of .cancellation to the certificate <br />holder(s) shown in the Schedule above, as follows: <br />t. To the name and address corresponding to each certificate of insurance holder indicated in <br />the Schedule above; and <br />2. At least 10 days prior to the effective date of the cancellation, as shown in our notice to the <br />first famed Insured, or, If Indicated, the longer number of days notice shown In the Schedule <br />above, <br />R NcrWthstandIng the foregoing, such notice of cancellation Is provided on an informational basis <br />and solely to assist You In Informing the certificate of Insurance holder(s) in advance of pending <br />cancollation in coverage to assist you in meeting Your contractual notice requirements to such <br />parties. Our failure to provide such advance notification to the certificate of insurance holder(s) <br />shown in the Schedule of this endorsement will not extend any policy cancellation date, negate <br />any cancellation of the policy, or grant, alter or extend any rights or obligations under this policy <br />and we shall have no liability for any failure to provide the notices) as provided herein. <br />All other terms and conditions of this policy regain unohanged. <br />This Form must be attached to Change Endorsement when issued after the policy is written. <br />One of the f1rsman`®FundInsurance Companlesas named in the policy <br />145977 1 -11 <br />0 eoloFioma,1's Fund Insurenco CorrMly, N%Wato, CA, Alf Hgflts reserved, <br />