Laserfiche WebLink
EXTENSION SCHEDULE OF UNDERLYING <br /> INSURANCE (Continued) THE <br /> HARTFORD <br /> POLICY NUMBER: 57 SBW BE3FCJ <br /> D. (X) Employer's Liability <br /> Carrier, Policy Number and Policy Period: Hartford Insurance Group <br /> 57W EGZS0250 <br /> 09/20/2025 To 09/20/2026 <br /> Type of Coverage Applicable Limits <br /> Employers Liability $1,000,000 Each Accident* <br /> $1,000,000 Each Employee by Disease* <br /> $1,000,000 Total Policy by Disease* <br /> *In any jurisdiction where the amount of Employers Liability Coverage afforded by the underlying insurer is by law <br /> unlimited, the limit stated does not apply and the policy of which this extension schedule forms a part shall afford no <br /> insurance with respect to Employers Liability in such jurisdiction. <br /> Form SU 00 03 10 18 Page 3 of 4 <br /> Process Date: 08/19/2025 ©2018, The Hartford Policy Expiration Date: 09/20/2026 <br /> (May include copyrighted material of Insurance Services Office, Inc., with its permission) <br />