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- mil <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />Nomd cawed <br />Reach Employee Assistance, Inc. <br />Nmer <br />15 <br />Additional <br />Numbv <br />AHM <br />149443 <br />2tl7f2014 to 2/17/2015 <br />41`17!2014 <br />wad ) <br />ACE Amen= Insurance Company <br />Additional Insured(s) Endorsement <br />It is agreed that the natural person(s) or organizetion(s) rioted by name as additional 'insured(s)' in the Schedule <br />below shall be considered additional 'insured(s)' under the Who Is An insured sec ions) of the applicable <br />Coverage Parts) Indicated in the Schedule below, but solely with respect to such additional 'Insured's' liability <br />arising solely out of: <br />1. if Professional Liability coverage is indicated for such additional ' insured', 'hesttixxre professional services' <br />performed by you or on your behalf for such addpfonal'insured; or <br />2. if General Liability coverage is indicated for such additional "insured', 'bodily injury', 'property damage' or <br />'personal or advertising injury caused by an'oocumence' or offense that was caused solely by. <br />a. you or your'employess' acting on your behalf,, and <br />b. within the scope of your duties to and performed on b~ of such addttional 'Insured'. <br />Where no coverage or defense shall apply herein for the Named Insured, no coverage or defense shall be <br />afforded to such additional 'insured(sr. This coverage shall not apply to any labM9y arising out of the sole <br />negligence of such additional insured(sr. <br />Schedule <br />Additional Insured: <br />Address: <br />Additional <br />Applicable Coverage Part: <br />Premium: <br />City of Santa Ana <br />Attn: Kathy Crook <br />Included <br />IS GENERAL LIABILITY <br />Employment Benefits M34 <br />P.O. Box 1958 <br />COVERAGE PART <br />Santa Ana, CA 92702 -1988 <br />® PROFESSIONAL LIABILITY <br />COVERAGE PART <br />This endorsement only applies to and amends coverage under this policy, including under any other Additional <br />Insureds) Endorsements thereto, for those additional 'insured(s)' listed in the Schedule above. If this policy <br />contains any other Additional Insured(s) Endorsements, then those endorsements remain in effect and are only <br />amended by the terms of this endorsement with respect to those additional 'Insured(s)' fisted in the Schedule <br />above. Coverage for any additional'insured(s)' not listed in the Schedule above remains unchanged. <br />All other terms, conditions and exclusions of this policy remain unchanged. <br />Mwim I i N-W, <br />Authorized Representative <br />PF- 12934e (08111) C ACE Limited, 2005, 2006.2007, 2011 Page 1 of 1 <br />Allied, FAC & LTC Primary <br />