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Attachment Code: D664321 Certificate ID: 19715405 <br /> IRONSHORE SPECIALTY INSURANCE COMPANY <br /> 175 Berkeley Street <br /> Boston, MA 02116 <br /> Toll Free: (877) IRON411 <br /> Endorsement#14 <br /> Policy Number: HC7CAB4HM9005 Effective Date of Endorsement:October 29,2024 <br /> Insured Name: HALCYON BEHAVIORAL LLC <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> AMEND DEFINITION OF INSURED ENDORSEMENT <br /> In consideration of the premium charged,the term "Insured," as defined in Section II DEFINITIONS of this Policy, is <br /> amended to include the following person and/or entities(each an "Additional Insured"): <br /> • Simple Therapy, Inc. <br /> • City of Santa Ana, its City Council,officers,officials,employees,agents, and volunteers <br /> 20 Civic Center Plaza <br /> Santa Ana,CA 92702 <br /> but only with respect to any Claim for any actual or alleged act,error or omission in the performance of,or failure to <br /> perform,a Managed Care Service or Private Information Protection by any Insured,other than any Additional Insured; <br /> provided that such Claim is made and continuously maintained against at least one Insured exclusive of any Additional <br /> Insured. <br /> All other terms, conditions and limitations of this Policy shall remain unchanged. <br /> MC.P.014(4.08 ed.) Page 1 of 1 <br />