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DATE <br /> SUPPLEMENT TO CERTIFICATE OF LIABILITY INS # 76907 JUN252024 <br /> DESCRIPTION OF OPERATIONS, LOCATIONS,VEHICLES <br /> The City of Santa Ana,Risk Management,it's officers,employees,agents,representatives,and volunteers are named as additional <br /> insured per form CG 20 38 12 19,CG 20 37 12-19,&CG 20 12 12-19 on the GL policy.Primary and Non-Contributory wording applies <br /> per form CG 20 01 12 19. Waiver of Subrogation in Favor of The City of Santa Ana per form CG 24 0412-19. <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 per form#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 /> 1 <br /> 0 oR.ti a Risk MaitagmnentDivision <br /> f L <br /> c REVIEWED&APPROVED 8Y: <br /> • A.rfu Acevtsda <br /> Risk Management Specialist <br /> /LCIIIIILdtC M /UM1/ <br />