Laserfiche WebLink
EXTENSION SCHEDULE OF UNDERLYING <br /> INSURANCE (Continued) THEE' <br /> HARTFORO <br /> POLICY NUMBER: 84 SBW BM5WFR <br /> E. () Foreign Liability <br /> Carrier, Policy Number and Policy Period: <br /> Type of Coverage Applicable Limits <br /> ( ) Foreign Commercial General Liability <br /> ( } Liability and Medical Expenses Per Occurrence <br /> ( } Personal And Advertising Injury Per Person/Organization <br /> ( } Products/Completed Operations Aggregate Aggregate <br /> ( } General Aggregate Aggregate <br /> ( } Damages To Premises Rented To You Any One Premises <br /> ( ) Foreign Contingent Auto Liability Each Accident <br /> () Foreign Employers Liability Each Accident* <br /> Each Employee by Disease* <br /> 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 4 of 4 <br /> Process Date: 0411 1/202 5 ©2018, The Hartford Policy Expiration Date: 0 613 0/20 2 6 <br /> (May include copyrighted material of Insurance Services Office, Inc., with its permission) <br />