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THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. WORKERS’ COMPENSATION BROAD FORM ENDORSEMENT EXTENDED OPTIONS Policy Number:72WECGD7152Endorsement Number: Effective Date:03/04/26Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address:TRUE NORTH RESEARCH 1588-1592 N COAST HWY 101 ENCINITASCA92024 Section I of this endorsement expands coverage provided under WC 00 00 00. Section II of this endorsement provides additional coverage usually only provided by endorsement. Section III of this endorsement is a Schedule of Covered States. You may use the index to locate these coverage features quickly: INDEX SUBJECTPAGESUBJECTPAGE SECTION I2B.Part One Does Not Apply3 PARTS ONE and TWO2C.Application of Coverage3 01We Will Also Pay2D.Additional Exclusions3 PART - THREE2E.West Virginia3 02How This Insurance Works2EXTENDED OPTIONS4 PART - SIX201Employers’ Liability Insurance4 03Transfer of Your Rights and Duties202Unintentional Failure to Disclose4 04Liberalization2Hazards SECTION II203Waiver of Our Right to Recover from4 VOLUNTARY COMPENSATION2Others INSURANCE04Foreign Voluntary Compensation4 05Voluntary Compensation Insurance2A.How This Reimbursement Applies4 A.How This Insurance Applies2B.We Will Reimburse4 B.We Will Pay3C.Exclusions4 C.Exclusions3D.Before We Pay5 D.Before We Pay3E.Recovery From Others5 E.Recovery From Others3F.Reimbursement For Actual Loss5 F.Employers’ Liability Insurance3Sustained EMPLOYERS’ LIABILITY STOP GAP3G.Repatriation5 ENDORSEMENTH.Endemic Disease5 06Employers’ Liability Stop Gap305Longshore and Harbor Workers’5 CoverageCompensation Act Coverage A.Stop Gap Coverage Limited to3Endorsement Montana, North Dakota, Ohio,SECTION III6 Washington, West Virginia and01Schedule of Covered States6 Wyoming Form WC 99 03 03 BPrinted in U.S.A. (Ed. 8/00)Page1 of6 Process Date:01/22/26Policy Expiration Date:03/04/27 © 2000, The Hartford