Laserfiche WebLink
POLICY NUMBER INSURED NAME AND ADDRESS <br />B 4034610293 FOCUS MEDIA GROUP, INC. <br />2271 W MALVERN AVE STE 407. <br />FULLERTON, CA 92833-2106 <br />POLICY CHANGES <br />ENDORSEMENT EFFECTIVE 1/15/2022 <br />This Change Endorsement changes the Policy. Please read it carefully. <br />This Change Endorsement is a part of your Policy and takes effect on the <br />effective date of your Policy, unless another effective date is shown. <br />The following Additional Insured(s) has (have) been added: <br />Form #:SB300120 Title: Additioal Insured - Owners, <br />Lessees or Contractors <br />Name and Address: <br />City of Santa Ana, its officers, officials, employees, and volunteers <br />Clerk of the City Council <br />20 Civic Center Plaza (M-30) <br />P.O. Box 1988 <br />Santa Ana, CA 92702-1988 <br />Chairman <br />� <br />G-56015-B (ED. 11/91) <br />E <br />s mnRbkMavgernentDhiafo. <br />Revt:o&APPROVaJ BY: <br />®' Risk Management Analyst <br />