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G -20472-A <br />(Ed. 10/93) <br />WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY <br />NOTICE OF CANCELLATION OR MATERIAL CHANGE ENDORSEMENT <br />In the event of cancellation or other material change of the policy, we will mail advance notice to the person or <br />organization named In the Schedule. The number of days advance notice Is shown In the Schedule. <br />This endorsement shall not operate directly or indirectly to benefit anyone not named In the Schedule. <br />Schedule <br />1. Number of days advance notice: 30 <br />2. Notice will be mailed to: <br />CITY OF SANTA ANA <br />20 CIVIC CENTER PLAZA <br />SANTA ANA, CA 92702 <br />G -20472-A Page 1 of 1 <br />(Ed. 10/93) <br />F"1111-VIDNED BY:1"4EUNK,'E: HEREI.M (F'G�04'7' <br />�11 114 110", � I <br />