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HEALTHCARE PROVIDERS <br />GENERAL LIABILITY COVERAGE PART ENDORSEMENT <br />Additional Insured — General Liability <br />In consideration of the premium paid, and subject to the General Liability limit of liability shown on the <br />certificate of insurance, it is agreed that the GENERAL LIABILITY COVERAGE PART is amended as <br />follows: <br />The person or entity named below (the "additional insured") is an insured under this Coverage Part but <br />only as respects its liability arising out of named insured's operations, or premises owned by or rented by <br />the named insured and solely to the extent that: <br />1. a general liability claim is made against the named insured and the additional insured; and <br />2. In any ensuing litigation arising out of such claim, the named insured and the additional insured <br />remain as co-defendants. <br />In no event is there any coverage provided under this policy for an occurrence that is the direct liability of <br />the additional insured. <br />Additional Insured: CITY OF SANTA ANA RISK MANAGEMENT DIVISION <br />20 CIVIC CENTER PLAZA <br />SANTA ANA CA 92702 <br />This endorsement Is a part of your policy and takes effect on the effective date of your policy, unless <br />another effective date is shown below. All other provisions of the policy remain unchanged. <br />Must Be Completed <br />ENDT. NO. I POLICY NO. <br />1 697816243 <br />Complete Only When This Endorsement Is Not Prepared with the Policy_ <br />Or Is Not to be Effective with the Policy <br />LUIS MARTINEZ <br />G-123827-B (07/2001) <br />AMERICAN CASUALTY COMPANY OF READING, PA <br />12/1 Ataneg�nmtrnvlrtnn <br />—t 3 At�nNm1&}{vPXWmeK <br />� 7orG �triwa�a = <br />—flnli Ma 9 nzn61 imlglde = <br />