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08/01/2008 15:42 19493056166 COLONIAL PRA PAGE 03/03 <br />This Endorsement Changes The Policy. Please Read /t Carefully. <br />ADDITIONAL INSURED ^- DESIGNATED <br />PERSON OR ORGANIZATION <br />This endorsement mnrlifies insurance provided uwlulur the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGF FORM <br />MEDICAL PROFESSIONAL LIABILITY COVERAGE FORM <br />In consideration of the premium charged, it is agreed that the coverages afforded by this policy are amended as <br />follows. <br />Section If — Who Is An Insured of the Commercial General Liabilit <br />following: y Coverage Part Is amended to include the <br />The City of Santa Ana, It's Officers, Employees, Agents, Volunteers and Representatives <br />62 CIVIC CENTER PLAZA <br />SANTA ANA, CA 927o2 <br />Coverage provided under this rnlicy is limited to Claims drisiiiy out or processional services at the medical clinic <br />or while in transport to a hospital or medical facility only, and performed by or on behalf of the Named Insured. <br />This policy does not provide coverage for any Bodily Injury or Property Damage arising out of acts which occur <br />beyond the srnre of the medical clinic, <br />Part I, sectiun E, Covered Persons and Entities of the Medical Professional Liability Coverage Part is <br />amended to include the following: <br />The City of Santa, Ana, It's Ofricers, Employees, Agents, Volunteers and Representatives <br />62 CIVIC CENTER PLAZA <br />SANTA ANA, CA 82702 <br />Coverage provided under this policy is limited to Claims arising out of profca3ional Services dl the medical clinic <br />or while in transport to a hospital or medical facility only, and performed by or on behalf of the Named Insured <br />This policy does not provide coverage arising out of acts which occur beyond the scope of the medical clinic. <br />TN3 endorsement effeLtivr <br />forms part of Policy Number <br />issued to <br />by <br />Endorsement No, <br />RSG 55003 0408 <br />