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* 81 * 06/25/2026 * GLP 3961460 05 00 Great American Assurance Company <br /> AMENDED 06/24/2026 *D/B* 072977484 262428 <br /> IL7002 ( Ed . 1007 ) <br /> Policy No: GLP 3961460 05 00 <br /> Effective Date of Change: 06-24-2026 <br /> POLICY CHANGES <br /> NAMED INSURED Backhaus Dance THIS ENDORSEMENT <br /> AND ADDRESS: PO Box 5890 CHANGES THE POLICY. <br /> Orange, CA 92863 <br /> PLEASE READ IT <br /> CAREFULLY. <br /> POLICY ALTERNATE MAILING ADDRESS: AGENT'S NAME AND ADDRESS: <br /> Maury Donnelly& Parr Inc <br /> 10150 York Rd <br /> STE 420 <br /> Cockeysville, MD 21030-3364 <br /> Insurance is afforded by the Company named below, a Capital Stock Corporation: <br /> Great American Assurance Company <br /> POLICY PERIOD: From: 06-03-2026 To: 06-03-2027 <br /> 12:01 A.M. Standard Time at the addresses of the Named Insured <br /> Additional Premium $0.00 <br /> It is hereby understood and agreed that this policy is amended as follows: <br /> Form CG2404- Waiver of Transfer of Rights of Recovery Against Others To Us Endorsement is added for the <br /> following: <br /> City of Santa Ana, its City Council, officers, officials, employees, agents, and volunteers <br /> 20 Civic Center Plaza, M-23 <br /> Santa Ana, CA 92701 <br /> Form CG2001- Primary and Noncontributory- Other Insurance Condition is added. <br /> Endorsement 1 <br /> FORMS AND ENDORSEMENTS here by added: <br /> CG2404, CG2001 <br /> FORMS AND ENDORSEMENTS here by amended: <br /> FORMS AND ENDORSEMENTS here by deleted: <br /> Agent Signature Date <br /> IL 70 02 (Ed. 10/07) Page 1 of 1 <br />