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Workers' Compensation and Employers' Liability Policy <br />Named Insured <br />TriNet Group, Inc. LCIF GROUP 4 ARCHITECTURE RESEARCH + <br />PLANNING, INC. <br />Endorsement Number <br />I Park Place, Suite 600 <br />Dublin, CA 94568-7983 <br />Policy Number <br />Symbol: WLR Number:C57886742 <br />Policy Period <br />Effective Date of Endorsement <br />10/19/2024TO 07/01/2025 <br />10/19/2024 <br />Issued By (Name of Insurance Company) <br />ACE American Insurance Company <br />Insert the policy number. The remainder of the information is to be completed only when this endorsement is Issued subsequent to the preparation of the policy. <br />This endorsement changes the policy to which it is attached and is effective on the dale issued unless otherwise stated. <br />NOTICE TO OTHERS ENDORSEMENT - SPECIFIC PARTIES <br />A. If we cancel this Policy prior to its expiration date by notice to you or the first Named insured for any reason other than <br />nonpayment of premium, we will endeavor, as set out below, to send written notice of cancellation, via such electronic or <br />other form of notification as we determine, to the persons or organizations listed in the schedule set out below (the <br />"Schedule"). You or your representative must provide us with both the physical and e-mail address of such persons or <br />organizations, and we will utilize such e-mail address or physical address that you or your representative provided to us <br />on such Schedule. <br />B. We will endeavor to send or deliver such notice to the e-mail address or physical address corresponding to each <br />person or organization indicated in the Schedule at least 30 days prior to the cancellation date applicable to the <br />Policy. <br />C. The notice referenced in this endorsement is intended only to be a courtesy notification to the person(s) or organization(s) <br />named in the Schedule in the event of a pending cancellation of coverage. We have no legal obligation of any <br />kind to any such person(s) or organization(s). Our failure to provide advance notification of cancellation to the person(s) <br />or organization(s) shown in the Schedule shall impose no obligation or liability of any kind upon us, our agents or <br />representatives, will not extend any Policy cancellation date and will not negate any cancellation of the Policy. <br />D. We are not responsible for verifying any information provided to us in any Schedule, nor are we responsible for any <br />incorrect information that you or your representative provide to us. If you or your representative does not provide us with <br />the information necessary to complete the Schedule, we have no responsibility for taking any action under this <br />endorsement. In addition, if neither you nor your representative provides us with e-mail and physical address information <br />with respect to a particular person or organization, then we shall have no responsibility for taking action with regard to <br />such person or entity under this endorsement. <br />E. We may arrange with your representative to send such notice in the event of any such cancellation. <br />F. You will cooperate with us in providing, or in causing your representative to provide, the e-mail address and physical <br />address of the persons or organizations listed in the Schedule. <br />G. This endorsement does not apply in the event that you cancel the Policy. <br />SCHEDULE <br />Name of Certificate Holder <br />E-Mail Address <br />Ph sical Address <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza <br />Santa Ana, CA 92702 <br />All other terms and conditions of this Policy remain unchanged. <br />This endorsement is not applicable in the states of AZ, FL, ID, ME, NC, NJ, NM, TX and WI. <br />Authorized Representative <br />Page t <br />