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SECOND AMENDMENT TO AGREEMENT THIS SECOND AMENDMENT TO AGREEMENT is entered into on July 7, 2008, by and between Luis D. Rivera, M.D., Inc. dba Medical Center of Santa Ana, a professional corporation ("Consultant") and the City of Santa Ana, a charter city and municipal corporation of the State of California ("City"). RECITALS: A. The parties entered into Agreement #2007-138, dated June 18, 2007, (hereinafter "said Agreement") by which Consultant has provided medical exams for City's Fire and Police personnel. B. In accordance with the terms and conditions of said Agreement, the parties wish to amend the Scope of Services to clarify the services to be provided, add compensation to pay for services during the 2008-09 fiscal year and extend the term of said Agreement for an additional one-year period \VHEREFORE, in consideration of the covenants contained in said Agreement, and subject to all the terms and conditions of said Agreement, except those amended in this Second Amendment to Agreement, the parties agree as follows: 1. Section I, SCOPE OF SERVICES, shall be deleted in its entirety and replaced with the following: "Consultant shall provide comprehensive physical examinations for all Fire sworn personnel and for those Police sworn personnel who elect to see Consultant as part of the annual wellness program, as set forth in Exhibit A-I, attached hereto. Additionally, Consultant shall provide low cost annual flu vaccinations for City employees." 2. Section 2, COMPENSATION, shall be amended to increase compensation by 570,00000 to pay for services during the 2008-09 fiscal year. 3. The Term of said agreement shall be extended for an additional one-year period, through June 30, 2009 4. Except as hereinabove amended, all terms and conditions of said Agreement shall remain in full force and effect. /1 25G-3