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CNA <br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not <br />enforce our right against the person or organization named in the Schedule. (This agreement applies only to the <br />extent that you perform work under a written contract that requires you to obtain this agreement from us.) <br />This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. <br />Schedule <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana, CA 92702 <br />The premium charge for the endorsement is reflected in the Schedule of Operations. <br />All other terms and conditions of the policy remain unchanged. <br />This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, <br />takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective <br />date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another <br />expiration date is shown below. <br />APPROV <br />1,� <br />Form No: WC 00 03 13 (04-1984) <br />Endorsement Effective Date: 11/15/17 Endorsement Expiration Date: 5/26/19 Endorsement No: 1 policy No: 6056677063, 6056953497 <br />Underwriting Company: Continental Insurance Company Policy Effective Date: 11 /15/2017 <br />Copyright 1983 National Council on Compensation Insurance. <br />