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Policy Number: Named Insured: Endorsement Number: Endorsement Effective: P100,325.866.2 KFB Management Inc. 15 06/11/2022 Hiscox Insurance Company Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NEW JERSEY CHANGES - LOSS INFORMATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ("OCCURRENCE" VERSION) The following Condition is added TO COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): 10.Your Right to Loss Information We will provide the first Named Insured shown in the Declarations the following loss information re- lating to this and any preceding general liability Coverage Part we have issued to you during the previous three years: a. A list or other record of each "occurrence" of which we were notified in accordance with pa- ragraph 2.a, of the Duties in the Event of Oc- currence, Offense, Claim or Suit Condition in this Section. We will include a brief description of the "occurrence" and information on whether any claim arising out of the "occurrence" is open or closed. b. A summary by policy year, of payments made and amounts reserved, stated separately under any applicable General Aggregate Limit and Products -Completed Operations Aggregate Limit. Amounts reserved are based on our judgment. They are subject to change and should not be re- garded as ultimate settlement values. You must not disclose this information to any clai- mant or any claimant's representative without our consent. We will provide this information only if we receive a written request from the first Named Insured dur- ing the policy period. We will provide this informa- tion within 45 days of receipt of the request. We compile claim and "occurrence" information for our own business purposes and exercise reasona- ble care in doing so. In providing this information to the first Named Insured, we make no representa- tions or warranties to insureds, insurers or others to whom this information is furnished by or on be- half of any insured. CG 26 20 10 93 Copyright, Insurance Services Office, Inc., 1992 9h�W&A"N Ory&r � - IOd �i�bi9tt RBkMma�emm[gnicatAidc 1'UIJC 1 UI 1