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TERRORISM RISK INSURANCE PROGRAM REAUTHORIZATION ACT <br />ENDORSEMENT <br />Limitation of Liability <br />The Act limits our liability to you under this policy. If aggregate Insured Losses exceed $100,000,000,000 <br />in a Program Year and if we have met our Insurer Deductible, we are not liable for the payment of any <br />portion of the amount of Insured Losses that exceeds $100,000,000,000; and for aggregate Insured <br />Losses up to $100,000,000,000, we will pay only a pro rata share of such Insured Losses as determined <br />by the Secretary of the Treasury. <br />Policyholder Disclosure Notice <br />State <br />California <br />Insured Losses would be partially reimbursed by the United States Government. If the <br />aggregate industry Insured Losses exceeds $100,000,000 in a Program Year, the United <br />States Government would pay 85% of our Insured Losses that exceed our Insurer <br />Deductible. <br />Notwithstanding item 1 above, the United States Government will not make any payment <br />under the Act for any portion of Insured Losses that exceeds $100,000,000,000. <br />The additional premium charged for the coverage for Insured Losses under the policy is <br />included in the deposit premium listed in Item 4 of the Declarations Page and is itemized in <br />the Schedule below. <br />SCHEDULE <br />Rate per $100 of Remuneration <br />I[fPLLI <br />All other terms and conditions of this Policy remain unchanged. <br />Endorsement Number: .3 <br />Policy Number: WCX 0055277 00 <br />Named Insured: Western Orange County Self- Funded Workers' Compensation Agency <br />This endorsement is effective on the inception date of this policy unless otherwise stated herein. <br />Endorsement Effective Date: July 1, 2013 <br />00 GL0253 00 (01 08) <br />Page 2 of 2 <br />Includes copyright material of the National Council on Compensation Insurance, Inc. with its permission. <br />© 2007 National Council on Compensation Insurance, Inc. <br />