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GENERAL CHANGE ENDORSEMENT <br />This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below: <br />Name of Insurance Company(ies) <br />Atain Specialty Insurance Company Atain Spec Insurance Company 100.0% GenLiab <br />Inception Date Expiration Date <br />11/9/2020 1/31/2021 <br />Endorsement Effective Policy Number Endorsement # <br />11/9/2020 1 CIP423084 1 <br />Named Insured <br />City of Santa Ana N(VW# <br />Countersigned By <br />(Authorized Representative) <br />IN CONSIDERATION OF TIM PREMIUM PREVIOUSLY CI-IARGED, IT IS HEREBY UNDERSTOOD AND AGREED <br />THAT TIi}3 POLICY IS AMENDED AS FOLLOWS: <br />THE SCHEDULE OF LOCATIONS IS HEREBY AMENDED TO READ FOR. NO FURTHER CHARGE: <br />LOCATION#1: 1 ST STREET/MAIN ST., SANTA ANA, CA 92701 <br />LOCATION#2: 31? D STREET/ MAINST. SANTAANA, CA 92701 <br />LOCATION43: 4TH STREET LOCATIONk /MAIN ST. SANTA AAA, CA 92701 <br />LOCATION44: 3RD STREET/BROAD WAY, SANTA ANA, CA 92701 <br />LOCATION#5: 4THSTREET/BROADiPA1; SANTAANA, CA 92701 <br />LOCATION#6: 57'HSTREET/BROADiPAI; SANTA ANA, CA 92701 <br />LOCATION47: 47II STREET/BUSH, SANTA ANA, CA 92701 <br />LOCATION#8: 1ST STREET/BRISTOLSTREET, SANTA AAA, CA 92701 <br />LOCATION0. 17TH STREET/BRISTOL STREET, SANTA AM, CA 92701 <br />LOCATION#10: MACARTHUR BLVD/BRISTOL STREET, SANTAANA, CA 92701 <br />LOC4TION411: AVINSTREET/MCF.4DDENAVE., SANTAANA, CA 92701 <br />LOCATION412: HARBOR BLVD/MCFADDENAVE., SAIM ANA, CA 92701 <br />LOCATION#13: GRAND/DYER, SANTA AAA, CA 92701 <br />LOCATION#14: 17TH STREET/CENTRE ON 17TH, SANTA ANA, CA 92701 <br />LOCATION015: 1ST STREET/DOWNTOWNPLAZA, SANTAANA, CA 92701 <br />LOCATION416: MAIN/WASHINGTOA, SANTAAAA, CA 92701 <br />LOCATION#17: RAITT/MACARTHUR BI,VD., SANTA ANA, CA 92701 <br />LOCATION418: GREENVILLE✓ALTON, SANTA ANA, CA 92701 <br />LOCATION#19: MATNS7RET"P/YVARNERAVE., SANTAANA, CA 92701 <br />LOCATION920: FLOkTIERSTREET/BISHOP, SANTA AAA, CA 92701 <br />All other terms and conditions remain unchanged. <br />knhom 12/4/2020 <br />Risk Mansgmed Dhisfon <br />� } REAEWEo&pAPPR APPROVED <br />BY: <br />M <br />Ruk ManaBemenC nnalyst <br />