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Docusign Envelope ID: B576D624-E16E-4D9F-BC67-5703DE54A6F8 <br /> UMBRELLA <br /> POLICY NUMBER: CUP-3R389058-24-I3 ISSUE DATE: 10/18/2024 <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> SCHEDULE OF UNDERLYING INSURANCE <br /> This endorsement modifies insurance provided under the following: <br /> EXCESS FOLLOW-FORM AND UMBRELLA LIABILITY INSURANCE <br /> Automobile Liability Limits Of Liability <br /> Carrier TRAVELERS PROPERTY CASUALTY Bodily Injury And Property $1,000,000 <br /> COMPANY OF AMERICA Damage Combined Single <br /> Limit <br /> Policy Number BA-003R329191-24 <br /> Policy Period <br /> From: 10/01/2024 <br /> to: 10/01/2025 <br /> Employers Liability Limits Of Liability <br /> Carrier TRAVELERS PROPERTY CASUALTY Bodily Injury By Accident $1,000,000* <br /> COMPANY OF AMERICA Each Accident <br /> Policy NumberUB-003R328606-24 Bodily Injury By Disease $1,000,000* <br /> Policy Limit <br /> Policy Period <br /> From: 10/01/2024 Bodily Injury By Disease $1,000,000* <br /> to: 10/01/2025 Each Employee <br /> *UNLIMITED IN THE STATE OF NEW YORK FOR <br /> SUBJECT EMPLOYEES <br /> Employee Benefits Liability Limits Of Liability <br /> Carrier THE PHOENIX INSURANCE COMPANY Each Employee $1,000,000 <br /> Aggregate $3,000,000 <br /> Policy Number 630-3R329314-24 <br /> Policy Period <br /> From: 10/01/2024 <br /> to: 10/01/2025 <br /> PRODUCER:ALERA GROUP INC OFFICE:CHANTILLY 21B <br /> EU 00 03 08 18 ©2018 The Travelers Indemnity Company.All rights reserved. Pagel of 2 <br />