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STATE Endorsement Agreement <br /> COMPENSATION <br /> INSURANCE Additional Insured Employer <br /> FUND <br /> 9304121-2025 <br /> Home Office Renewal <br /> San Francisco NA <br /> All Effective Dates are <br /> at 12:01 AM Pacific Page 1 of 1 <br /> Standard Time or the <br /> Time Indicated at Effective September 9, 2025 at 12:01 AM <br /> Pacific Standard Time <br /> VICON ENTERPRISE INCORPORATED <br /> 5433 E SPYGLASS WAY <br /> ANAHEIM, CA 92807-4625 <br /> Anything in this policy to the contrary notwithstanding, it is agreed that <br /> CITY OF SANTA ANA <br /> is hereby named as an additional insured employer on this policy but only as respects <br /> employees whose names appear on the payroll records of <br /> VICON ENTERPRISE INCORPORATED <br /> (Herein called the primary insured) while those employees are engaged in work under <br /> the simultaneous direction and control of the primary insured and the additional insured <br /> employer. <br /> It is further agreed that the payment of the full premium due and payable under this policy <br /> shall remain the sole responsibility of the primary insured. <br /> Nothing in this endorsement shall be held to vary, alter,waive or extend any of the terms, conditions, <br /> agreements,or limitations of this policy other than as above stated.Nothing elsewhere in this policy shall <br /> be held to vary,alter,waive or limit the terms, conditions,agreements or limitations in this endorsement. <br /> Countersigned and Issued at San Francisco September 10, 2025 <br /> f � <br /> 0015 Authorized Representative President and CEO SF—END <br /> Rev.2/2025 OLD DP 217 <br />