CARE AMBULANCE SERVICES, INC. (2)

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Endorsement General Purpose Endorsement ZURICH Policy No. Eff. Date of Pol. E)p. Date of Pol. Eff. Date of End. Producer Add'I Prem. Return Prem, UMB 5414770-05 October 1, 2018 October 1, 2019 October 1, 2018 18591000 --- --- Named Insured and Mailing Address: Producer: Feick USA, Inc. Willis of Seattle, Inc. 1517 W. Braden Court 600 University Street, #3100 Orange, CA 92868 Seattle, WA 98101 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided underthe following: HEALTH CARE EXCESS LIABILITY POLICY Paragraph 3. Persons or Entitles Insured of Section II: General Policy Provisions is amended to include as an additional insured the person or organization shown in the Schedule of this endorsement, whom you are required to add as an additional insured on this policy under a written contractor written agreement. Such person or organization is an additional insured but only because of liabilitycaused in whole or in part by your acts or omissions. The insurance provided bythis endorsement will not be broaderthan that provided bythe "governing underlying insurance policy'. Subparagraph D., Cancellation, of Paragraph 6., Conditions, is amended to include the following: If we cancelthis insurance by written notice to the first "Named Insured" for any reason otherthan nonpayment of premium, we will provide 30 -day written notice to the additional insured listed in the Schedule below. However, this advance notification of pending cancellation of coverage is intended as a courtesy only and our failure to provide such advance notification will not extend the effective date of cancellation nor negate cancellation of this insurance. Subparagraph M., Transfer of Any "Insured's" Rights and Duties, of Paragraph 6., Conditions, is amended to include the following: If the first "Named Insured" is required by written contract or agreement with the person or organization shown in the Schedule below to waive its rights of recovery, we agree to waive our rights of recovery. This waiver of rights onlyapplies to the extent required by written contract, however, the contract must be entered into prior to the "occurrence" or "medical incident" that gives rise to a claim and shall not be construed to be a waiver with respect to any other operations in which the first "Named Insured" has no contractual interest. SCHEDULE Name of Person or Organization (Additional Insured): City of Santa Ana ALL OTHERTERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. 10-3 -2oly APPROVED U-HCU-405-A CW (2/10) Page 1 of 1