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DocuSign Envelope ID:38427522-A9AA-41C8-927D-729D2EA76C3E <br /> AGENCY CUSTOMER ID:SUBMHOL-01 ELAM <br /> LOC#: 1 <br /> AFRO ADDITIONAL REMARKS SCHEDULE Page 1 of 1 <br /> AGENCY License#0757776 NAMED INSURED <br /> HUB International Insurance Services Inc. Submittable Holdings Inc.DBA Submittable <br /> 111 N.Higgins Ave.,Suite 200 <br /> POLICY NUMBER Missoula,MT 59802-4401 <br /> SEE PAGE 1 <br /> CARRIER NAIC CODE <br /> SEE PAGE 1 SEE P 1 EFFECTIVE DATE:SEE PAGE 1 <br /> ADDITIONAL REMARKS <br /> THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br /> FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance <br /> Description of Operations/Locations/Vehicles: <br /> Policy Carrier: Scottsdale Indemnity Company <br /> Policy Number: EKI3367837 <br /> Policy Limits: $2,000,000 <br /> Policy Dates: 2/19/2021 —2/19/2022 <br /> Employment Practices Liability <br /> Policy Carrier: Scottsdale Indemnity Company <br /> Policy Number: EKI3367837 <br /> Policy Limits: $2,000,000 <br /> Policy Dates: 2/19/2021 —2/19/2022 <br /> ERISA Bond <br /> Policy Carrier: Hartford Fire Insurance Company <br /> Policy Number: 57BDDHK4909 <br /> Policy Limits: $385,000 <br /> Policy Dates: 2/19/2020—2/19/2023 <br /> ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />