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POLICY CHANGE (Continued) <br />Policy Number: 72 SBM AH6839 <br />Policy Change Number: 001 <br />ADDITIONAL INSURED 02 - OWNERS, LESSEE OR CONTRACTORS IS ADDED <br />FORM SS4170 <br />NAME THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, AND <br />REPRESENTATIVES <br />ADDRESS 20 CIVIC CENTER PLAZA SANTA ANA, CA 92701 <br />FORM NUMBERS OF ENDORSEMENTS REVISED AT ENDORSEMENT ISSUE: <br />SS 41 70 06 11 <br />FORM NUMBERS OF ENDORSEMENTS ADDED AT ENDORSEMENT .ISSUE: <br />TH12001183 ADDITIONAL INSURED - VENDOR <br />Form SS 12 11 04 05 T Page 002 <br />Process Date: 12/22/15 Policy Effective Date: 01/06/16 <br />Policy Expiration Date: 01/06/17 <br />