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FOLLOW FORM EXCESS LIABILITY <br />SCHEDULE OF UNDERLYING INSURANCE <br />UNDERLYING <br />LIMITS OF INSURANCE <br />POLICY <br />CARRIER & <br />POLICY TYPE <br />PERIOD <br />POLICY NUMBER <br />Commercial Automobile <br />$ 1,000,000 Liability - Combined Single Limit <br />07/01/2019 <br />Great Divide Insurance <br />to <br />Company <br />07/01/2020 <br />BAP2018652-13 <br />Employer's Liability — <br />$ 1,000,000 BI by Disease - Policy Aggregate <br />07/01/2019 <br />Great Divide Insurance <br />Coverage B <br />Limit <br />to <br />Company <br />07/01/2020 <br />WCA2018653-13 <br />$ 1,000,000 BI by Disease - Each Employee <br />Limit <br />$ 1,000,000 BI by Accident - Each Accident <br />Limit <br />General Liability <br />$ 1,000,000 Personal & Advertising Injury Limit <br />07/01/2019 <br />Nautilus Insurance Company <br />to <br />ECP2018650-13 <br />$ 1,000,000 Employee Benefit Liability— <br />07/01/2020 <br />Aggregate Limit <br />$ 2,000,000 General Aggregate Limit (Other <br />than Products/Completed <br />Operations) <br />$ 1,000,000 Employee Benefit Liability— Each <br />Employee Limit <br />$ 1,000,000 Each Occurrence Limit <br />$ 2,000,000 Products/Completed Operations <br />Aggregate Limit <br />Pollution/Professional <br />$ 1,000,000 Contractors Pollution Liability Limit <br />07/01/2019 <br />Nautilus Insurance Company <br />to <br />ECP2018650-13 <br />$ 1,000,000 Professional Liability Limit <br />07/01/2020 <br />The coverages above are provided in the underlying policies as listed. <br />FORMS AND ENDORSEMENTS (NOTE: Please read the policy forms and endorsements carefully.): <br />E001J 03 17 Nautilus Policy Jacket <br />ENV DIR CLAIMS 06 19 Policyholder Notice - Claim Reporting Information <br />FFX DEC 07 18 Excess Liability Policy Declarations <br />ENV FORMS 09 10 Schedule of Forms and Endorsements <br />FFX 8000 07 18 <br />D-2 FORM 01 17 <br />E906CA (06-07) <br />ENV 2012 01 12 <br />FFX 8002 07 18 <br />FFX 8029 07 18 <br />Excess Liability Insurance Policy <br />California Surplus Lines Notice <br />Service of Suit - California <br />Earned Premium and Flat Rate <br />Schedule of Underlying Insurance <br />Microbial Substance Exclusion <br />MCS-90 01 17 Endorsement for Motor Carrier Policies of Insurance for Public Liability Under Sections 29 and <br />30 of the Motor Carrier Act of 1980 <br />ENV 2225 10 18 Exclusion of Certified Acts of Terrorism <br />IL 12 02 01 16 Office of Foreign Asset Control (OFAC) Exclusion Endorsement <br />FFX BINDER 07 18 <br />U 1 <br />1 Page 2 of 3 <br />