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PROOF OF INSURANCE (2026 - 2026)A� " CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 9/3/2025 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 Gaspar Insurance Services - SV 23161 Ventura Blvd. #100 Woodland Hills CA 91364 CONTACT NAME: PHONE FAX No : AIC No Ext : 818-302-3060 (A No): ADDARESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Federal Insurance Company 20281 License#: L100460 INSURED HIGHINC-02 INSURERB: The Hartford Insurance Group, Inc. 914 HigherGround, Inc. 275 E. Hillcrest Dr. Suite 160-108 INSURER C: Technology Insurance Company, Inc. 42376 INSURER D : Thousand Oaks CA 91360 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:2005116242 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR OF INSURANCE ADDLSUBRTYPE INSD WVD POLICY NUMBER POLICY EFF MM DDIIYYYY POLICY EXP MM DD LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 35777893 6/17/2025 6/17/2026 EACH OCCURRENCE $1,000,000 FIVI CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence 1 $ 000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑ JECT PRO ❑ LOC X PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: A AUTOMOBILE LIABILITY 73508488 6/17/2025 6/17/2026 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ X HIRED LNON-OWNED AUTOS ONLY AUTOS ONLY A UMBRELLA LIAB X OCCUR 79806728 6/17/2025 6/17/2026 EACH OCCURRENCE $ 10,000,000 X AGGREGATE $ 10,000,000 EXCESS LIAB CLAIMS -MADE DED X RETENTION $ n $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE Y 72WECBU3DIU 6/17/2025 6/17/2026 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? NIA E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 C Technology E&O/Prof Liab ES00440472969 9/1 /2025 9/1 /2026 Claim & Agg $21M / $21M C Cyber Liability ES00440472969 9/1 /2025 9/1 /2026 Claim & Agg Deductible $4M / $4M $10,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of El Segundo, its officials, and employees is listed as additional insured under General Liability policy. Primary and Non-contributory applies in favour of City of El Segundo (Forms will follow). 30 days notice of cancellation/10 days notice of non-payment. (Forms will follow). Primary/Non-Contributory and 30 day NOC endorsements are included but must be issued by carrier. 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. City of El Segundo 350 Main St AUTHORIZED REPRESENTATIVE C'2� 4e"�'e El Segundo CA 90245 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD E- H U B B" General Liability Supplementary b. release attachments; Payments but only for bond amounts within the available Limit Of Insurance. We do not have to (continued) furnish these bonds. C. reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of such claim or suit, including actual loss of earnings up to $ 1000 a day because of time off from work. D. costs taxed against the insured in the suit, except any: 1. attorney fees or litigation expenses; or 2. other loss, cost or expense; in connection with any injunction or other equitable relief. E. prejudgment interest awarded against the insured on that part of a judgment we pay. If we make an offer to pay the applicable Limit Of Insurance, we will not pay any prejudgment interest based on that period of time after the offer. F. interest on the full amount of a judgment that accrues after entry of the judgment and before we have paid, offered to pay or deposited in court the part of the judgment that is within the applicable Limit Of Insurance. Supplementary Payments does not include any fine or other penalty. These payments will not reduce the Limits Of Insurance. Our obligation to make these payments ends when we have used up the applicable Limit Of Insurance. Coverage Territory This insurance applies anywhere, provided the insured's responsibility to pay damages, to which this insurance applies, is determined in a suit on the merits brought in the United States of America (including its possessions and territories), Canada or Puerto Rico, or in a settlement to which we agree. I �7 007 rM Sole Proprietorships If you are an individual, you and your spouse are insureds; but you and your spouse are insureds only with respect to the conduct of a business of which you are the sole owner. If you die: • persons or organizations having proper temporary custody of your property are insureds; but they are insureds only with respect to the maintenance or use of such property and only for acts until your legal representative has been appointed; and • your legal representatives are insureds; but they are insureds only with respect to their duties as your legal representatives. Such legal representatives will assume your rights and duties under this insurance. Liability Insurance Form 80-02-2000 (Rev. 4-01) Contract Page 5 of 32 Who Is An Insured (continued) Partnerships Or Joint If you are a partnership (including a limited liability partnership) or a joint venture, you are an Ventures insured. Your members, your partners and their spouses are insureds; but they are insureds only with respect to the conduct of your business. Limited Liability If you are a limited liability company, you are an insured. Your members and their spouses are Companies insureds; but they are insureds only with respect to the conduct of your business. Your managers are insureds; but they are insureds only with respect to their duties as your managers. Other Organizations If you are an organization (including a professional corporation) other than a partnership, joint venture or limited liability company, you are an insured. Your directors and officers are insureds; but they are insureds only with respect to their duties as your directors or officers. Your stockholders and their spouses are insureds; but they are insureds only with respect to their liability as your stockholders. Employees Your employees are insureds; but they are insureds only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, no employee is an insured for: A. bodily injury, advertising injury or personal injury: 1. to you, to any of your directors, managers, members, officers or partners (whether or not an employee) or to any co -employee while such injured person is either in the course of his or her employment or while performing duties related to the conduct of your business; 2. to the brother, child, parent, sister or spouse of such injured person as a consequence of any injury described in subparagraph A.1. above; or 3. for which there is any obligation to share damages with or repay someone else who must pay damages because of any injury described in subparagraphs A.1. or A.2. above. With respect to bodily injury only, this limitation does not apply to: • you or to your directors, managers, members, officers, partners or supervisors as insureds; or • your employees, as insureds, with respect to such damages caused by cardio- pulmonary resuscitation or first aid services administered by such an employee; or B. property damage to any property owned, occupied or used by you or by any of your directors, managers, members, officers or partners (whether or not an employee) or by any of your employees. This limitation does not apply to property damage to premises while rented to you or temporarily occupied by you with permission of the owner. Liability Insurance Form 80-02-2000 (Rev. 4-01) Contract Page 6 of 32 H U B B" General Liability Who Is An Insured (continued) Volunteers Persons who are volunteer workers for you are insureds; but they are insureds only for acts within the scope of their activities for you and at your direction. Real Estate Managers Persons (other than your employees) or organizations acting as your real estate managers are insureds; but they are insureds only with respect to their duties as your real estate managers. Permissive Users Of With respect to mobile equipment registered in your name under a motor vehicle registration law: Mobile Equipment A. persons driving such equipment on a public road with your permission are insureds; and B. persons or organizations responsible for the conduct of such persons described in subparagraph A. above are insureds; but they are insureds only with respect to the operation of the equipment and only if no other insurance of any kind is available to them. However, no person or organization is an insured with respect to: • bodily injury to any co -employee of the person driving the equipment; or • property damage to any property owned or occupied by or loaned or rented to you, or in your charge or the charge of the employer of any person who is an insured under this provision. Vendors Persons or organizations who are vendors of your products are insureds; but they are insureds only with respect to their liability for damages for bodily injury or property damage resulting from the distribution or sale of your products in the regular course of their business and only if this insurance applies to the products -completed operations hazard. However, no such person or organization is an insured with respect to any: • assumption of liability by them in a contract or agreement. This limitation does not apply to the liability for damages for bodily injury or property damage that such vendor would have in the absence of such contract or agreement; • representation or warranty unauthorized by you; • physical or chemical change in your products made intentionally by the vendor; • repackaging, unless unpacked solely for the purpose of inspection, demonstration or testing, or the substitution of parts under instruction from the manufacturer and then repacked in the original container; • failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business in connection with the distribution or sale of your products; • demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of your products; or • of your products which, after distribution or sale by you, have been labeled or relabeled or used as a container, ingredient or part of any other thing or substance by or for the vendor. Liability Insurance Form 80-02-2000 (Rev. 4-01) Contract Page 7 of 32 Who Is An Insured Vendors Further, no person or organization from whom you have acquired your products, or any container, (continued) ingredient or part entering into, accompanying or containing your products, is an insured under this provision. Lessors Of Equipment Persons or organizations from whom you lease equipment are insureds; but they are insureds only with respect to the maintenance or use by you of such equipment and only if you are contractually obligated to provide them with such insurance as is afforded by this contract. However, no such person or organization is an insured with respect to any: • damages arising out of their sole negligence; or • occurrence that occurs, or offense that is committed, after the equipment lease ends. Lessors Of Premises Persons or organizations from whom you lease premises are insureds; but they are insureds only with respect to the ownership, maintenance or use of that particular part of such premises leased to you and only if you are contractually obligated to provide them with such insurance as is afforded by this contract. However, no such person or organization is an insured with respect to any: • damages arising out of their sole negligence; • occurrence that occurs, or offense that is committed, after you cease to be a tenant in the premises; or • structural alteration, new construction or demolition operations performed by or on behalf of them Subsidiary Or Newly If there is no other insurance available, the following organizations will qualify as named insureds: Acquired Or Formed 0 a subsidiary organization of the first named insured shown in the Declarations of which, at Organizations the beginning of the policy period and at the time of loss, such first named insured controls, either directly or indirectly, more than fifty (50) percent of the interests entitled to vote generally in the election of the governing body of such organization; or 0 a subsidiary organization of the first named insured shown in the Declarations that such first named insured acquires or forms during the policy period, if at the time of loss such first named insured controls, either directly or indirectly, more than fifty (50) percent of the interests entitled to vote generally in the election of the governing body of such organization. Limitations On Who Is An A. Except to the extent provided under the Subsidiary Or Newly Acquired Or Formed Insured Organizations provision above, no person or organization is an insured with respect to the conduct of any person or organization that is not shown as a named insured in the Declarations. B. No person or organization is an insured with respect to the: 1. ownership, maintenance or use of any assets; or 2. conduct of any person or organization whose assets, business or organization; Liability Insurance Form 80-02-2000 (Rev. 4-01) Contract Page 8 of 32 E- H U B B° General Liability Who Is An Insured Limitations On Who Is An you acquire, either directly or indirectly, for any: Insured bodily injury or property damage that occurred; or (continued) • advertising injury or personal injury arising out of an offense first committed; in whole or in part, before you, directly or indirectly, aquired such assets, business or organization. Limits Of Insurance The Limits Of Insurance shown in the Declarations and the rules below fix the most we will pay, regardless of the number of: • insureds; • claims made or suits brought; or • persons or organizations making claims or bringing suits. The Limits Of Insurance apply separately to each consecutive annual period and to any remaining period of less than twelve (12) months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional period of less than twelve (12) months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limits Of Insurance. General Aggregate Limit Subject to the Each Occurrence Limit, the General Aggregate Limit is the most we will pay for the sum of: • damages for bodily injury and property damage, except damages included in the products -completed operations hazard; and • medical expenses. Products -Completed Subject to the Each Occurrence Limit, the Products -Completed Operations Aggregate Limit is the Operations Aggregate most we will pay for the sum of damages for bodily injury and property damage included in the Limit products -completed operations hazard. Advertising Injury And The Advertising Injury And Personal Injury Aggregate Limit is the most we will pay for the sum of Personal Injury Aggregate damages for advertising injury and personal injury. Limit Each Occurrence Limit The Each Occurrence Limit is the most we will pay for the sum of: • damages for bodily injury and property damage; and • medical expenses; arising out of any one occurrence. Any amount paid for damages or medical expenses will reduce the amount of the applicable aggregate limit available for any other payment. Liability Insurance Form 80-02-2000 (Rev. 4-01) Contract Page 9 of 32 Limits Of Insurance Each Occurrence Limit If the applicable aggregate limit has been reduced to an amount that is less than the Each (continued) Occurrence Limit, the remaining amount of such aggregate limit is the most that will be available for any other payment. Damage To Premises Subject to the Each Occurrence Limit, the Damage To Premises Rented To You Limit is the most Rented To You Limit we will pay for the sum of damages for property damage to any one premises while rented to you or temporarily occupied by you with permission of the owner. Medical Expenses Limit Subject to the Each Occurrence Limit, the Medical Expenses Limit is the most we will pay for the sum of medical expenses, under Medical Expenses coverage, for bodily injury sustained by any one person. Bodily InjUrylPrOperty None of the following exclusions, except "Contracts", "Expected Or Intended Injury" and "Loss In Damage Exclusions Progress", apply to property damage to premises while rented to you or temporarily occupied by you with permission of the owner. Aircraft, Autos Or This insurance does not apply to bodily injury or property damage arising out of the ownership, Watercraft maintenance, use (use includes operation and loading or unloading) or entrustment to others of any: • aircraft; • auto; or • watercraft; owned or operated by or loaned or rented to any insured. This exclusion does not apply to: A. a watercraft while ashore on premises owned by or rented to you; B. a watercraft you do not own, provided that it: 1. is less than fifty-five (55) feet long; and 2. does not transport persons or cargo for a charge; C. the parking of an auto on premises owned by or rented to you, provided the auto is not owned by or loaned or rented to you or the insured; D. the liability for damages assumed in an insured contract resulting from the ownership, maintenance or use, by others, of an aircraft or watercraft; E. the operation of the equipment described in subparagraphs F.2. or F.3. of the definition of mobile equipment, or F. an aircraft you do not own, provided that: 1. the pilot in command holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating that person as a commercial or airline transport pilot; Liability Insurance Form 80-02-2000 (Rev. 4-01) Contract Page 10 of 32 Conditions Duties In The Event Of F. Knowledge of an occurrence or offense by an agent or employee of the insured will not Occurrence, Offense, constitute knowledge by the insured, unless an officer (whether or not an employee) of any Claim Or Suit insured or an officer's designee knows about such occurrence or offense. (continued) G. Failure of an agent or employee of the insured, other than an officer (whether or not an employee) of any insured or an officer's designee, to notify us of an occurrence or offense that such person knows about will not affect the insurance afforded to you. H. If a claim or loss does not reasonably appear to involve this insurance, but it later develops into a claim or loss to which this insurance applies, the failure to report it to us will not violate this condition, provided the insured gives us immediate notice as soon as the insured is aware that this insurance may apply to such claim or loss. Legal Action Against Us No person or organization has a right under this insurance to: join us as a party or otherwise bring us into a suit seeking damages from an insured; or sue us on this insurance unless all of the terms and conditions of this insurance have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured obtained after an actual: trial in a civil proceeding; or arbitration or other alternative dispute resolution proceeding; but we will not be liable for damages that are not payable under the terms and conditions of this insurance or that are in excess of the applicable Limits Of Insurance. Other Insurance If other valid and collectible insurance is available to the insured for loss we would otherwise cover under this insurance, our obligations are limited as follows. Primary Insurance This insurance is primary except when the Excess Insurance provision described below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in the Method of Sharing provision described below. Excess Insurance This insurance is excess over any other insurance, whether primary, excess, contingent or on any other basis: A. that is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar insurance for your work; B. that is insurance that applies to property damage to premises rented to you or temporarily occupied by you with permission of the owner; C. if the loss arises out of aircraft, autos or watercraft (to the extent not subject to the Aircraft, Autos Or Watercraft exclusion); Liability Insurance Form 80-02-2000 (Rev. 4-01) Contract Page 22 of 32 Conditions (continued) Transfer Or Waiver Of We will waive the right of recovery we would otherwise have had against another person or Rights Of Recovery organization, for loss to which this insurance applies, provided the insured has waived their rights Against Others of recovery against such person or organization in a contract or agreement that is executed before such loss. To the extent that the insured's rights to recover all or part of any payment made under this insurance have not been waived, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring suit or transfer those rights to us and help us enforce them. This condition does not apply to medical expenses. Liability Insurance Form 80-02-2000 (Rev. 4-01) Contract Page 24 of 32 Endorsement Policy Period JUNE 17, 2025 TO JUNE 17, 2026 Effective Date JUNE 17, 2025 Policy Number 3577-78-93 WUC Insured HIGHERGROUND, INC. DBA: HG TECHNOLOGIES Name of Company FEDERAL INSURANCE COMPANY Date Issued MARCH 20, 2025 This Endorsement applies to the following forms: COMMON POLICY CONDITIONS Conditions Cancellation The following changes are made as respects exposures in the state of California Under Conditions, the provisions titled Cancellation and When We Do Not Renew are deleted and replaced by the following: The first named insured may cancel this policy or any of its individual coverages at any time by sending us a written request or by returning the policy and stating when thereafter cancellation is to take effect. A. All Policies In Effect For 60 Days or Less If this policy has been in effect for less than 60 days and is not a renewal of a policy we have issued, we may cancel this policy or any of its individual coverages by mailing or delivering to the first named insured at the mailing address shown in the policy and to the producer of record, advance written notice of cancellation, stating the reason for cancellation and effective date of cancellation at least: 1. 20 days before the effective date of cancellation if we cancel for: a. nonpayment of premium; or b. discovery of fraud by: (1) any insured or his or her representative in obtaining this insurance; or Policy Conditions California Mandatory — Cancellation And Nonrenewal continued Form 80-02-9717 (Rev. 9-15) Endorsement Page 1 Cancellation (continued) (2) you or your representative in pursuing a claim under this policy. 2. 60 days before the effective date of cancellation if we cancel for any other reason. B. All Policies In Effect For More Than 60 Days If this policy has been in effect for more than 60 days, or is a renewal of a policy we issued, we may cancel this policy or any of its individual coverages only upon the occurrence, after the effective date of the policy, of one or more of the following: a. Nonpayment of premium, including payment due on a prior policy we issued and due during the current policy term covering the same risks. b. Discovery of fraud or material misrepresentation by: (1) any insured or his or her representative in obtaining this insurance; or (2) you or your representative in pursing a claim under this policy. C. A .judgment by a court or an administrative tribunal that you have violated a California or Federal law, having as one of its necessary elements an act which materially increases any of the risks insured against. d. Discovery of willful or grossly negligent acts or omissions, or of any violations of state laws or regulations establishing safety standards, by you or your representative„ which materially increase any of the risks insured against. e. Failure by you or your representative to implement reasonable loss control requirements, agreed to by you as a condition of policy issuance, or which were conditions precedent to our use of a particular rate or rating plan, if that failure materially increases any of the risks insured against. f. A determination by the Commissioner of Insurance that the: (1) loss of, or changes in, our reinsurance covering all or part of the risk would threaten our financial integrity or solvency; or (2) continuation of the policy coverage would place us in violation of California law or the laws of the state where we are domiciled or threaten our solvency. g. A change by you or your representative in the activities or property of the commercial or industrial enterprise, which results in a materially added, increased or changed risk, unless the added, increased or changed risk is included in the policy. 2. We will mail or deliver advance written notice of cancellation, stating the reason for cancellation and effective date of cancellation to the first named insured at the mailing address shown on the policy and to the producer of record at least: a. 20 days before the effective date of cancellation if we cancel for a reason listed in B. La. or b. above; or b. 60 days before the effective date of cancellation if we cancel for any other reason listed in paragraph B. 1. Conditions Form 80-02-9717 (Rev. 9-15) California Mandatory — Cancellation And Nonrenewai Endorsement continued Page 2 E- H U B B° Policy Conditions Endorsement Policy Period Effective Date Policy Number Insured Name of Company Date Issued This Endorsement applies to the following forms: COMMON POLICY CONDITIONS Conditions Notice Of Cancellation To Scheduled Persons Or Organizations When We Cancel Policy Conditions JUNE 17, 2025 TO JUNE 17, 2026 JUNE 17, 2025 3577-78-93 WUC HIGHERGROUND, INC. DBA: HG TECHNOLOGIES FEDERAL INSURANCE COMPANY MARCH 20, 2025 Under Conditions, the following condition is added. When we cancel this policy for any reason, other than non-payment of premium, we will notify person(s) or organization(s) shown in the Schedule at least 30 days in advance of the cancellation date. Any failure by us to notify such person(s) or organization(s) will not: • impose any liability or obligation of any kind upon us; or • invalidate such cancellation. Schedule Person(s) or Organization(s): CITY OF GARDEN GROVE ITS OFFICERS, OFFICIALS, AGENTS, EMPLOYEES, AND VOLUNTEERS Address: 11222 ACACIA PARKWAY GARDEN GROVE, CA 92840 Person(s) or Organization(s): CITY OF EL SEGUNDO ITS OFFICIALS, AND EMPLOYEES Address: 350 MAIN ST. EL SEGUNDO, CA 90245 Notice Of Cancellation To Scheduled Persons Or Organizations (Except Non -Payment Of Premium) continued Form 80-02-9779 (Ed. 3-11) Endorsement Page 1 • 1 • • [wonfifinglof All other terms and conditions remain unchanged. Authorized Representative Notice Of Cancellation To Scheduled Persons Or Organizations Policy Conditions (Except Non -Payment Of Premium) last page Form 80-02-9779 (Ed. 3-11) Endorsement Page 2