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C H U B B® Liability Insurance <br />Endorsement <br />Policy Period <br />Effective Dale <br />Policy Number <br />Insured <br />Name of Company <br />Date Issued <br />This Endorsement applies to the following forms: <br />GENERAL LIABILrI Y <br />EMPLOYEE BENEFITS ERRORS OR OMISSIONS <br />Conditions <br />August 1, 2021 -August 1, 2022 <br />August 1, 2021 <br />3579-87-11 <br />HOLLAND & KNIGHT <br />GREAT NORTHERN INSURANCE COMPANY <br />Under Conditions, the following provision is added to the condition titled Other Insurance. <br />Other Insurance - If you are obligated, pursuant to a written contract or agreement, to provide the person or <br />Primary, Noncontributory organization described in the Schedule (that is also included in the Who Is An Insured section of this <br />Insurance - Scheduled contract) with primary insurance such as is afforded by this policy, then this insurance is primary and <br />Person Or Organization we will not seek contribution from insurance available to such person or organization. <br />Schedule <br />AS REQUIRED BY WRITTEN CONTRACT <br />All other terms and conditions remain unchanged. <br />Author►`zed Representative <br />Liabirty Insurance Cmditbns - Other Insurance - Primary, Nonccmtributory Insurance - Schedules <br />Form 80.02 2M (Rev. 7-09) Endorsement <br />e , RiskManWmentDMsian <br />�e 77 1°x REVIEWED & APPROVED BY: <br />V"° <br />--� Risk janagement Analyst <br />