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s Declarations- s <br />Employment Practices <br />B <br />Liability Coverage Part <br />s s s <br />CONTINUED <br />POLICY PERIOD EFFECTIVE DATE: 11/23/2020 EXPIRATION DATE: 11/23/2021 <br />12:01 A.M., Standard time at the address of the named insured as stated herein. Exception: 12 noon in New <br />Hampshire. <br />LIMITS OF LIABILITY <br />EACH CLAIM LIMIT: $25,000 <br />ANNUAL AGGREGATE LIMIT: $25,000 <br />RETROACTIVE DATE: 11/23/2019 <br />If no date is entered, the Retroactive Date is the same as the effective date of this Coverage Part. <br />DEDUCTIBLE: $ Each claim <br />Form Numbers of Forms and Endorsements that apply: <br />FORM NUMBER <br />FORM NAME <br />SL 55 74 10 18 <br />DECLARATIONS - EMPLOYMENT PRACTICES LIABILITY COVERAGE PART <br />SL 55 36 10 18 <br />THIRD PARTY LIABILITY ENDORSEMENT - EMPLOYMENT PRACTICES LIABILITY <br />SL 55 34 10 18 <br />WAGE AND HOUR CLAIMS EXPENSES - EMPLOYMENT PRACTICES LIABILITY <br />SL 55 37 10 18 <br />RETROACTIVE DATE ENDORSEMENT - EMPLOYMENT PRACTICES LIABILITY <br />SL 55 02 10 18 <br />EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM (CLAIMS MADE) <br />Countersigned by <br />Authorized Representative <br />Form: SL 55 74 10 18 <br />Process Date: 10/12/2020 <br />Policy Expiration Date: 11/23/2021 <br />10/12/2020 <br />Date <br />ew cF IZAManagk:medDMsian <br />�40 1°x REVIEWED & APPROVED SY.- <br />V"° <br />--� Risk Pjanagement Analyst <br />