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DATE <br />SUPPLEMENT TO CERTIFICATE OF LIABILITY INS # 79915 JUN242025 <br />DESCRIPTION OF OPERATIONS, LOCATIONS, VEHICLES <br />City of Santa Ana, its City Council, its officers, officials, employees, agents, and volunteers are to be covered as additional insureds <br />with respect to liability arising out of work or operations performed by or on behalf of the Permittee including materials, parts, <br />equipment, and personnel furnished in connection with such work or operations per form CG 20 38 12 19, CG 20 37 12-19, & CG 20 12 <br />12-19 on the GL policy. Primary and Non -Contributory wording applies per form CG 20 01 12 19. Waiver of Subrogation in Favor of <br />The City of Santa Ana per form CG 24 04 12-19. <br />Additional Insured, Primary & Non -Contributory Wording, and Waiver of Subrogation applies per forms (50461AIS01, 500PNCV01, <br />50461SWF01) on the Auto policy. <br />Waiver of Subrogation on the WC Policy perform #10217 <br />Certificate of Insurance shall provide thirty (30) day prior written notice of cancellation per attached form UTS-410g (2-11). <br />Professional Liability - $2,000,000 per occurrence and $2,000,000 aggregate <br />$5,000,000 Excess to follow the GL, AUTO, WC per the attahced Dec Pages. <br />Those usual to the insured's operations. <br />uertmcate ;F 0 <br />