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Additional Insured - Lessor Endorsement <br />This endorsement modifies insurance provided under the following: <br />ALLIED HEALTHCARE PROVIDERS PROFESSIONAL <br />AND SUPPLEMENTAL LIABILITY POLICY <br />In consideration of the premium paid, this policy is amended as follows <br />Section III. Insured is amended to include the following entity or entities as an additional Insured, but only <br />with respect to their liability arising of the Insured's use, operation, or maintenance of the premises listed (if <br />different from mailing address in the Declarations). <br />Additional Insured Name and Mailing Address: <br />City of Santa Ana, its Officers, Agents, and Employees <br />20 Civic Center Plaza <br />Santa Ana, CA, 92702 <br />Premises Address (if different from mailing address shown on the Declarations) <br />"Revised, effective 11/08/2017, at no additional premium. at the premium of $0.00 <br />All other terms and conditions of this policy remain unchanged. This endorsement is part of your policy and <br />takes effect on the effective date of your Policy, unless another effective date is shown below. <br />Policy: 081041 <br />Effective on and after: 11/08/2017 <br />Issued to: Wesley A Bosch <br />Expiration date: 08/21/2018 <br />PI-PHCP-03 (07/10) <br />By: Robert O'Leary, Authorized Representative <br />UO <br />