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DocuSign Envelope ID: 78F206FF-A138-4129-88A7-AC03812E2BD1 <br /> 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: <br /> County of Orange <br /> State of North Carolina <br /> 200 South Cameron Street <br /> Hillsborough <br /> NC Zip Code. . . 27278 <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 Complete Only When This Endorsement Is Not Prepared with the Policy <br /> Or Is Not to be Effective with the Policy <br /> ENDT. NO. POLICY NO. ISSUED TO ENDORSEMENT EFFECTIVE DATE <br /> 1 613252987 Institute of Art Therapy 8/10/2015 <br /> Inc dba The Art <br /> Therapy Institute <br /> G-123827-B (07/2001) Page 1 of 1 <br />