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Docusign Envelope ID: EA5FA554-045E-485E-9A91-382EC978E817 <br /> This Qualified Assignment and Release Agreement is signed in one or more counterparts as of the Effective <br /> Date by the following: <br /> Assignor(1): Berkley Public Entity -Gemini Insurance Company <br /> By: <br /> Authorized Representative(s) <br /> Title: <br /> Assignor(2): The City of Santa Ana <br /> By: <br /> Authorized Representative(s) <br /> Alvaro Nunez ATTEST <br /> Title: City Manager <br /> dal - <br /> Hal! .� <br /> erl <br /> Assignee: Pacific Life &Annuity Services, Inc. Assignee: Pacific Life & Annuity Services, Inc. <br /> By: By: <br /> Authorized Representative Authorized Representative <br /> Title: Title: <br /> Claimant(s): Olivia Guerrero, a minor, by and through her guardian ad litem,Theresa Ramirez <br /> By: ittn Se u,ivrA) <br /> Approved as to Form and Content: <br /> Clayman 's Attorney <br /> PL QAR Page 6 of 6 v2023 <br />