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Page 1 of 1MIL 1212 04 17 <br />EVANSTON INSURANCE COMPANY <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />POLICY CHANGES <br />Policy Change Number: 2 <br />POLICY NUMBER <br />MKLV5PSM000796 <br />POLICY CHANGES EFFECTIVE <br />01/17/2024 <br />COMPANY <br />Evanston Insurance Company <br />COVERAGE PARTS AFFECTED <br />Specified Medical Professions Professional Liability Insurance Coverage Part <br />General Liability Insurance Coverage Part – Claims Made Coverage <br />In consideration of the premium paid, it is hereby understood and agreed that Waiver Of Subrogation For Scheduled <br />Additional Insured(s), MESM 2060 03 21, is added as attached, effective the date stated above.. <br />All other terms and conditions remain unchanged. <br /> NO CHANGES ADDITIONAL PREMIUM <br />$ <br />RETURN PREMIUM <br />$ <br /> TO BE ADJUSTED AT <br />AUDIT <br />CHANGES <br />AUTHORIZED REPRESENTATIVE <br />RT Specialty Insurance Services, LLC <br />44 Montgomery Street, Suite 2000 <br />San Francisco, CA 94104 <br />NAMED INSURED <br />Bay Area PL Services <br />This endorsement forms a part of the policy numbered below: <br />Authorized Representative Signature <br />Docusign Envelope ID: EAC72FF0-2F63-4ADB-9A2E-1E009CC6908F