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DNA Workers Compensation And Employers Liability Insurance <br /> Policy Endorsement <br /> NOTICEOF • OR MATERIAL CHANGE ENDORSEMENT <br /> This endorsement modifies insurance provided under the WORKERS COMPENSATION AND EMPLOYERS <br /> LIABILITY INSURANCE POLICY: <br /> In the event of cancellation or material change that reduces or restricts coverage during the policy period, we <br /> agree to send prior written notice in the manner prescribed, to the person or organization listed in the Schedule. <br /> SCHEDULE <br /> 1. Number of days advance notice: <br /> For nonpayment of premium: <br /> 10 <br /> For any other reason: <br /> 30 <br /> 2. Name and Address of Person or Organization: <br /> City of Santa Ana, its City Counsel, officers, officials,employees, agents and volunteers <br /> 20 Civic Center Plaza, M-43 <br /> Santa Ana CA 92702 USA <br /> Form No: CNA87380XX (1 1-2016) Policy No:WC 8018834966 <br /> Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date:04/01/2026 <br /> Endorsement No: 2; Page: 1 of 1 Policy Page:1 of 1 <br /> Underwriting Company: American Casualty of Readings PA, 151 N Franklin St, Chicago, IL 60606 <br /> °Copyright CNA All Rights Reserved. <br />