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06/06/24 08/02/25 <br />SENTINEL INSURANCE COMPANY, LIMITED <br />22 SBW AF0636 08/02/24 TO 08/02/25 <br />$1,000,000 <br />$2,000,000 <br />$1,000,000 <br />X $1,000,000 <br />X $2,000,000 <br />HARTFORD ACCIDENT & INDEMNITY CO 22UECNA6914 <br />X <br />$1,000,000 <br />HARTFORD CASUALTY INS CO 22WBCCQ9796 08/02/24 TO 08/02/25 <br />X $ 500,000 <br />$ 500,000 <br />$ 500,000 <br />Form SX 80 04 10 08 Page 1 of 2 <br />Process Date:Policy Expiration Date: <br />EXTENSION SCHEDULE OF <br />UNDERLYING INSURANCE POLICIES <br />This extension schedule forms a part of the policy designated in the Declarations. <br />Carrier, Policy Number and Policy Period: <br />A. <br />Type of Coverage Applicable Limits <br />( X ) Business Liability - including:Bodily Injury and Property Damage <br />Liability Combined <br />each occurrence <br />general aggregate <br />Employees as Additional Insureds <br />Contractual Liability <br />Limited Non-Owned Watercraft <br />Additional Insureds <br />Damages To Premises Rented To You Property Damage Liability <br />each occurrence <br />( ) Personal and Advertising Injury <br />( ) Products/Completed Operations Prod./Comp. Ops. <br />aggregate <br />( ) Hired Auto and Non-Owned Auto Limit of Liability <br />B. <br />( ) Comprehensive Automobile Liability - <br />Owned Automobiles <br />( ) Non-Owned Automobiles <br />08/02/24 TO 08/02/25 <br />Bodily Injury Liability <br />each person <br />each accident <br />Property Damage Liability <br />each accident <br />Bodily Injury and Property Damage <br />( ) Hired Automobiles Liability Combined <br />each accident <br />( ) Uninsured Motorist each occurrence <br />C. <br />( ) Employer’s Liability each accident* <br />each employee by <br />disease* <br />total policy by disease* <br />D. <br />( ) Liquor Liability <br />An "X" marked in the box indicates the coverage is provided in the Underlying Policies. <br />(Note Maintenance of Underlying Insurance Condition SX 80 02 or SX 80 03) <br />*Except that in any jurisdiction where the amount of Employers Liability Coverage afforded by the underlying <br />insurer is by law unlimited, the limit stated does not apply and the policy of which this extension schedule <br />forms a part shall afford no insurance with respect to Employers Liability in such jurisdiction. <br />Docusign Envelope ID: 016C7FF8-5EB3-4D21-A006-0A8906E60E75