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PROOF OF INSURANCE (2021) CLOSEDMGTOFAM-01 CRYSTAL HC vKL! CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) `.� 6/19/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER (CONTACT NAME: Earl Bacon Agency, Inc. PHONE FAX Post Office Box 12039 (A/C, No, Ext): (850) 878-2121 (A/C, No):(850) 878-2128 Tallahassee, FL 32317 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: American Casualty Company of Reading, PA 20427 INSURED INSURER B: Continental Casualty Company 20443 MGT of America, LLC INSURER C: Transportation Insurance Company 20494 MGT of America Consulting, LLC 4320 West Kennedy Blvd. INSURER D: Travelers Casualty and Surety Company of America 31194 Tampa, FL 33609-2118 INSURER E: Zurich American Insurance Company 16535 I INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRA'T OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH 'OLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY 'AID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MM/DD/YYYYI (MM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR X X 5095130327 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO ❑ LOC JECT OTHER A AUTOMOBILE LIABILITY $ 5,000,000 ANY AUTO X X 2093563501 OWNED SCHEDULED 5,000,000 AUTOS ONLY AUTOS X HIRED X NON -OWNED $ AUTOS ONLY AUTOS ONLY B X UMBRELLA LIABX OCCUR EXCESS LIAB ILII CLAIMS -MADE 2093563496 DED I X I RETENTION $ 10,000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y 7/1/2021 ANY PROPRIETOR/PARTNER/EXECUTIVE X 3011086788 ❑ NIA OFFICER/MEMBER EXCLUDED? A (Mandatory in NH) $ If yes, describe under DESCRIPTION OF OPERATIONS below $ 1,000,000 D Professional/Cyber 105638880 E Directors & Officers MPL44400773-00 7/1/2020 7/1/2021 DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Anv one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OPAGG $ COMBINED SINGLE LIMIT (Ea accident) $ 7/1/2020 7/1/2021 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ 300,000 15,000 1,000,000 2,000,000 2,000,000 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Blanket Additional Insured per attached forms CG2010; CG2037; CNA750779XX; CA20480299 Blanket Waiver of Subrogation per attached forms CNA75008XX; G19160B; CA04440310 Notice of Cancellation to Certificate Holders per attached forms CC68021A; CNA72315XX CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE City of EI Segundo 010�140T 350 Main Street EI Seaundo. CA 90245 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD EACH OCCURRENCE $ 5,000,000 7/1/2020 7/1/2021 (AGGREGATE 5,000,000 $ X STATUTE EERH 7/1/2020 7/1/2021 1,000,000 E.L EACH ACCIDENT $ E.L DISEASE - EA EMPLOYEE $ 1,000,000 E.L DISEASE -POLICY LIMIT $ 1,000,000 7/1/2020 7/1/2021 2,500,000 Occur/Agg 5,000,000 2/24/2020 2/24/2021 5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Blanket Additional Insured per attached forms CG2010; CG2037; CNA750779XX; CA20480299 Blanket Waiver of Subrogation per attached forms CNA75008XX; G19160B; CA04440310 Notice of Cancellation to Certificate Holders per attached forms CC68021A; CNA72315XX CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE City of EI Segundo 010�140T 350 Main Street EI Seaundo. CA 90245 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLiCY NUMBER INSURED P 24193563501 MGT 0T AMERICA CONSULTING, LLMC. 4320 WEST KENNEDY BLVD. TAMPA, FL 33609-21..1.6 COMMERCIAL AUTOMOBILE LOSS PAYEE SCHEDULE OAny doss Payee that has a financial interest in a. covered B"'a t a* for which we are, providing Physical dama.ge coves.ge fo that covered °auto " under this policy.,:, INSURED Page e 6 of 13 FEW M a P6LICY NUMBER INSURED NAME AND ADDRESS P 2093'563501 MGT OF AMERICA CONSULTING, LLC. 4320 WEST KENNEDY BLVD. TAMPA, FL 33609-2118 ADDITIONAL INSURED - LESSOR SCHEDULE "Any Lessor of a covered Illautou for which we are providing any coverage for that, covered "'auto" under this pol,ic!y.n INSURED Page 9 of 13 POLICY NUMBER: 2093563501 COMMERCIAL AUTO CA 04 44 03 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Endorsement Effective Date: SCHEDULE Name(s) Of Person(s) Or Organization(s): PER ISSUED CERTIFICATE Information required to complete this Schedule, if not shown above, will be shown in the Declarations. x 0 The Transfer Of Rights Of Recovery Against Others To Us Condition does not apply to the person(s) or s organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident' or the 'loss" under a contract with that person or organization. CA 04 44 03 10 Copyright, Insurance Services Office, Inc., 2009 Page 1 of 1 I ilOTICE OF CA OR ORGANIZATION qigip�� q -1 us, 10 Days if we cancel for non-payment of premium. 30 Days if the policy is cancelled for any other reason, or if coverage is restricted or reduced by endorsement. C 1 '.. 1� A = Name: PER ISSUED CERTIFICATE Attention: Street Address: City, State, ZIP: e-mail address: All other terms and conditions of the Policy remain unchanged. CNA72315XX (02/13) Page 1 of 1 Insured Name: MGT OF AMERICA CONSULTING, LLC. Copyright CNA All Rights Reserved. Policy: 2093563501 POLICY NUMBER: COMMERCIAL AUTO CA 04 44 03 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Endorsement Effective Date: SCHEDULE Name(s) Of Person(s) Or Organization(s): PER ISSUED CERTIFICATE Information required to complete this Schedule, if not shown above, will be shown in the Declarations. x 0 The Transfer Of Rights Of Recovery Against Others To Us Condition does not apply to the person(s) or s organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident' or the 'loss" under a contract with that person or organization. CA 04 44 03 10 Copyright, Insurance Services Office, Inc., 2009 Page 1 of 1 Workers Compensation And Employers Liability Insurance CNA M I l, 1, 11, , II , l 111 :tn II It is understood and agreed that: If you have agreed under written contract to provide notice of cancellation to a party to whom the Agent oT Record has issued a Certificate of Insurance, and if we cancel a policy term described on that Certificate of Insurance for any reason other than nonpayment of premium, then notice of cancellation will be provided t# such Certificate Holders at least 30 days in advance of the date cancellation is effective. Any failure by us to notify such persons or organizations will not extend or invalidate such cancellation, or impose any liability or obligation upon us or the Agent of Record. MM This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below. Form No: CC68021 A (02.2013) Policy No: WC 3 11086712 Policyholder Notice; Page: 1 of 1 Underwriting Company: Valley Forge Insurance Company, 151 N Franklin St, Chicago, IL 60606 11 Copyright CNA All Rights Reserved. Workers Compensation And Employers Liability Insurance aw !oo�O _ This endorsement changes the policy to which it is attached. bio agreed that Part Onm-VVorhera' Compensation Insurance G. Recovery From Others and Part Two - Employers' Liability Insurance H. Recovery From Others are amended byadding the following: We will not enforce our right to recover against persons or organizations. (This agreement applies only tothe extent that you perform work under a written contract that requires you to obtain this agreement from us.) PREK8|DKD CHAHGE- Refer to the Schedule of Operations The charge will be an amount to which you and we agree that is a percentage ofthe total standard premium for California exposure. The amount ia2Y6. All other terms and conditions of the policy remain unchanged. This endorsement which forms e part of and is for attachment tothe policy issued by the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said poUcy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date inshown below. : Underwriting Company: Transportation Insurance Company, 151 N Franklin St, Chicago, IL 60606 *Copyright CNA All Rights Reserved. ................ CNA CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors - with Products -Completed Operations Coverage Endorsement i his endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is understood and agreed as follows: I. WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily injury, property damage or personal and advertising injury caused in whole or in part by your acts or omissions, or the acts or omissions of those acting on your behalf: A. in the performance of your ongoing operations subject to such written contract; or B. in the performance of your work subject to such written contract, but only with respect to bodily injury or property damage included in the products -completed operations hazard, and only if: 1. the written contract requires you to provide the additional insured such coverage; and 2. this coverage part provides such coverage. II. But if the written contract requires: A. additional insured coverage under the 11-85 edition, 10-93 edition, or 10-01 edition of CG2010, or under the 10- 01 edition of CG2037; or B. additional insured coverage with "arising out of language; or C. additional insured coverage to the greatest extent permissible by law; then paragraph I. above is deleted in its entirety and replaced by the following: WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily injury, property damage or personal and advertising injury arising out of your work that is subject to such written contract. III. Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide 0 such additional insured with: 0 A. coverage broader than required by the written contract; or s B. a higher limit of insurance than required by the written contract. 0 N s IV. The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property damage, or personal and advertising injury arising out of. A. the rendering of, or the failure to render, any professional architectural, engineering, or surveying services, including: 1. the preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and 2. supervisory, inspection, architectural or engineering activities; or B. any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this coverage part. V. Under COMMERCIAL GENERAL LIABILITY CONDITIONS, the Condition entitled Other Insurance is amended to add the following, which supersedes any provision to the contrary in this Condition or elsewhere in this coverage part: CNA75079XX (10-16) Policy No: 5095130327 Page 1 of 2 AMERICAN CASUALTY CO OF READING,PA Insured Name: MGT OF AMERICA CONSULTING, LLC. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Primary and Noncontributory Insurance CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors - with Products -Completed Operations Coverage Endorsement ---------------- With respect to other insurance available to the additional insured under which the additional insured is a named insured, this insurance is primary to and will not seek contribution from such other insurance, provided that a written contract requires the insurance provided by this policy to be: 1. primary and non-contributing with other insurance available to the additional insured; or 2. primary and to not seek contribution from any other insurance available to the additional insured. But except as specified above, this insurance will be excess of all other insurance available to the additional insured. VI. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the addition of the following: Any additional insured pursuant to this endorsement will as soon as practicable: 1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim; 2. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the investigation, defense, or settlement of the claim; and 3. make available any other insurance, and tender the defense and indemnity of any claim to any other insurer or self -insurer, whose policy or program applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory, this paragraph 3. does not apply to insurance on which the additional insured is a named insured. The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice of a claim from the additional insured. VII. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended to add the following definition: Written contract means a written contract or written agreement that requires you to make a person or organization an additional insured on this coverage part, provided the contract or agreement: A. is currently in effect or becomes effective during the term of this policy; and B. was executed prior to: 1. the bodily injury or property damage; or 2. the offense that caused the personal and advertising injury; for which the additional insured seeks coverage. Any coverage granted by this endorsement shall apply solely to the extent permissible by law. on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently . ! Policy. Page of AMERICAN CASUALTY CO OF READING,PA Insured OF AMERICA Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. !17-M rim 1111,05 SCHEDULE Name Of Person Or Organization: ANY PERSON OR ORGANIZATION WHOM THE NAMED INSURED HAS AGREED IN WRITING IN A CONTRACT OR AGREEMENT TO WAIVE SUCH RIGHTS OF RECOVERY, BUT ONLY IF SUCH CONTRACT OR AGREEMENT: 1. IS IN EFFECT OR BECOMES EFFECTIVE DURING THE TERM OF THIS COVERAGE PART; A11r, 2. WAS EXECUTED PRIOR TO THE BODILY INJURY, PROPERTY DAMAGE OR PERSONAL AND ADVERTISING INJURY GIVING RISE TO THE CLAIM. (Information required to complete this Schedule, if not shown above, will be shown in the Declarations.) Under COMMERCIAL GENERAL LIABILITY CONDITIONS, it is understood and agreed that the condition entitled Transfer Of Rights Of Recovery Against Others To Us is amended by the addition of the following: With respect to the person or organization shown in the Schedule above, the Insurer waives any right of recovery the Insurer may have against such person or organization because of payments the Insurer makes for injury or damage arising out of the Named Insured's ongoing operations or your work included in the products -completed operations hazard. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes ix tXe eKective.. . • . . r r • - • - - - .. • . - . and expires concurrently with s. Policy. C7500 (10-16) PolicyNo: 5095130327 Page 1 of 1 AMERICAN CASUALTY CO OF READING,PA Insured Name: MGT OF AMERICA CONSULTING, LLC. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission, CNA CNA PARAMOUNT General Aggregate Limit - Per Project Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is understood and agreed as follows: I. For each single construction or service project away from premises the Named Insured owns or rents, a separate Project General Aggregate Limit, equal to the amount of the General Aggregate Limit shown in the Declarations, is the most the Insurer will pay for the sum of. A. all damages under Coverage A, except damages because of bodily injury or property damage included in the products -completed operations hazard; and B. all medical expenses under Coverage C; that arise from occurrences or accidents which can be attributed solely to ongoing operations at that project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations, nor the Project General Aggregate Limit applicable to any other project. II. All: A. damages under Coverage B, regardless of the number of locations or projects involved; B. damages under Coverage A, caused by occurrences which cannot be attributed solely to ongoing operations at a single project, except damages because of bodily injury or property damage included in the products - completed operations hazard; and C. medical expenses under Coverage C, caused by accidents which cannot be attributed solely to ongoing operations at a single project, will reduce the General Aggregate Limit shown in the Declarations. III. The limits shown in the Declarations for Each Occurrence, for Damage To Premises Rented To You and for Medical Expense continue to apply, but will be subject to either the Project General Aggregate Limit or the General Aggregate Limit shown in the Declarations, depending on whether the occurrence can be attributed solely to ongoing operations at a particular project. IV. When coverage for liability arising out of the products -completed operations hazard is provided, any payments for damages because of bodily injury or property damage included in the products -completed operations hazard will reduce the Products -Completed Operations Aggregate Limit shown in the Declarations, regardless of the number of projects involved. V. If a single construction or service project away from premises owned by or rented to the Named Insured has been abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, such project will still be deemed to be the same project. VI. The provisions of LIMITS OF INSURANCE not otherwise modified by this endorsement shall continue to apply as stipulated. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA75061XX (1-15) Policy No: 5095130327 Page 1 of 1 AMERICAN CASUALTY CC) OF READING,PA Insured Name: MGT OF AMERICA CONSULTING, LLC. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. CNA CNA PARAMOUNT Additional Insured - Owners, Lessees or Contractors - Completed Operations Endorsement bisunderstood and agreed aofollows: A. Section U —VVho Is An |maunmd is amended to include as an additional insured the parson(s) ororganizabon(s) shown in the Schedule, but only with respect to liability for bodily injury or property damage caused, knwhole orin part, by your work at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the products -completed operations hazard. 1. The insurance afforded tosuch additional insured only applies to the extent permitted by law; and 2. Ifcoverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III —Limits Of Ifcoverage provided hothe additional insured is required byacontract oragreement, the most wewill pay onbehalf of the additional insured isthe amount nfinsurance: 1. Required bythe contract nragreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown inthe Declarations. Page 2 of 2 AMERICAN CASUALTY Insured Name: MGT OF CO OF READING,PA AMERICA CONSULTING, LLC. Copyright Insurance Services Office, Inc., 2012 Additional Insured - Owners, Lessees or Contractors - Scheduled Person or Organization Endorsement A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for bodily injury, property damage or personal and advertising injury caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to bodily injury or property damage occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG (04-13) Page 2 of 2 ffiwi'ml- CO OF READING,PA AMERICA CONSULTING, LLC. Copyright Insurance Services Office, Inc., 2012 CNA Workers Compensation And Employers Liability Insurance Policy Endorsement 11 fill z €.. We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Any person or organization for which the employer has agreed by written contract, executed prior to loss, may execute a waiver of subrogation. However, for purposes of work performed by the employer in Missouri, this waiver of subrogation does not apply to any construction group of classifications as designated by the waiver of right to recover from others (subrogation) rule in our manual. Schedule Any Person or Organization on whose behalf you are required to obtain this waiver of our right to recover from under a written contract or agreement. The premium charge for the endorsement is reflected in the Schedule of Operations. All other terms and conditions of the policy remain unchanged. This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers,; takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below. Form No: WC 00 03 13 (04-1984) Endorsement Effective Date: Endorsement Expiration Date: Endorsement No: 23; Page: 1 of 1 Underwriting Company: Valley Forge Insurance Company, 151 N Franklin St, Chicago, IL 60606 Copyright 1983 National Council on Compensation Insurance. Policy No: WC 3 11086712 Policy Effective Date: 07/01 /2019 Policy Page: 223 of 344 CAMp p YWorkers Com ensation And Em to ers Liability Insurance °n:ulllic: uII:,11 uu II utlu ,;u It is understood and agreed that: If you have agreed under written contract to provide notice of cancellation to a party to whom the Agent of Record has issued a Certificate of Insurance, and if we cancel a policy term described on that Certificate of Insurance for any reason other than nonpayment of premium, then notice of cancellation will be provided to such Certificate Holders at least 30 days in advance of the date cancellation is effective. If notice is mailed, then proof of mailing to the last known mailing address of the Certificate Holder on file with the Agent of Record will be sufficient to prove notice. Any failure by us to notify such persons or organizations will not extend or invalidate such cancellation, or impose any liability or obligation upon us or the Agent of Record. All other terms and conditions of the policy remain unchanged. This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below. Form No: CC68021 A (02-2013) Policyholder Notice; Page: 1 of 1 Underwriting Company: Transportation Insurance Company, 151 N Franklin St, Chicago, IL 60606 ° Copyright CNA All Rights Reserved. Policy No: WC 3 11086788 x Changes - Notice of Cancellation or Material Restriction Endorsement This endorsement modifies insurance provided under the following. - COMMERCIAL GENERAL LIABILITY COVERAGE PART EMPLOYEE BENEFITS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVELIABILITY COVERAGE • PART STOP GAP LIABILITY COVERAGE PART TECHNOLOGY ! • AND OMISSIONS LIABILITY COVERAGE PART SPECIAL PROTECTIVE AND HIGHWAY LIABILITY POLICY - NEW YORK DEPARTMENT OF TRANSPORTATION Number of days notice (other than for nonpayment of premium): ---------- 30 Number of days notice for nonpayment of premium: 0 Name of person or organization to whom notice will be senty per issued certificate CNA74702XX1-1 Page 1 of 2 AMERICAN CASUALTYCOF READING,PA Insured T OF AMERICACONSULTING LLC . pyrlght CNA All Rlghls Reserved. •« .5095130327 I F? CNAPARAMOUNT CNA Changes - Notice of Cancellation or Material Restriction Endorsement If no entry appears above, the number of days notice for nonpayment of premium will be 10 days. It is understood and agreed that in the event of cancellation or any material restrictions in coverage during the policy period, the Insurer also agrees to mail prior written notice of cancellation or material restriction to the person or organization listed in the above Schedule. Such notice will be sent prior to such cancellation in the manner prescribed in the above schedule. This endorsement, which forms a part of and is for attachment t the Policy issued by the designated Insurers, takes effect on t effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. I CNA74702XX 01-15 otic o: 5095130327 Page 2 of 2 Endorsement No: 22 AMERICAN CASUALTY CO OF READINC ,PA Insured Name: MGT OF AMERICA CONSULTING LLC. Copyright CNA AU Rights Reserved. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIRD PARTY NOTIFICATION OF CANCELLATION OR NONRENEWAL ENDORSEMENT Woug=P 1 0 _ It is agreed that: In the event the Named Insured or the Company elect to cancel or not renew this Liability Policy, the Company will provide notice of such cancellation or nonrenewal to the Specified Person or Organization shown below at the corresponding Specified Person or Organization's Address shown below. ,Specified., Pems or Organization,; S-pecified. Person or Organization's Address; per issued certificate Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions,exclusions or limitations of the above-mentioned policy, except as expressly stated herein. This endorsement is part of such policy and incorporated therein. Issuing Company: Travelers Casualty and Surety Company of America liolicy Number: 105638880 MPL-10020 Ed. 12-11 Page 1 of 1 C 2011 The Travelers Indemnity Company. All rights reserved.