2024-03-02_CTR055977_Matrix_New_World_GAUWP.pdf

03/06/2023

United Assurance Inc 16-00 Pollitt Dr

Fair Lawn NJ 07410

Jennifer Fugate

(201) 797-6600 (201) 797-4455 j.fugate@unitedassurance.com

Matrix New World Engineering, Land Surveying and Landscape Architecture, P.26 Columbia Tpke

Florham Park NJ 07932

Nautilus Insurance Company 17370 Allmerica Financial Benefit 41840 Great Divide Insurance Company 25224

CL233230953

A Contractual Liability Pollution Liablity Y Y ECP2017341-17 03/02/2023 03/02/2024

2,000,000 100,000 5,000 2,000,000 2,000,000 2,000,000

Pollution Limit $2MM Ea.Claim

B Y Y AWY7938199 03/02/2023 03/02/2024

1,000,000

Medical payments 5,000

A Y Y FFX2017342-17 03/02/2023 03/02/2024

10,000,000 10,000,000

C N WCA2017343-18 03/02/2023 03/02/2024

1,000,000 1,000,000 1,000,000

A Professional Liability

ECP2017341-17 03/02/2023 03/02/2024

Each Claim $2,000,000 Aggregate $2,000,000

As per contract with Matrix New World Engineering, Land Surveying and Landscape Architecture, PC - Contract No. CTR055977.

The State of Arizona and its departments, agencies, boards, commissions, universities, officers, officlas, agents, and employees are listed as Additional Insured with regards to the General Liability and Automobile Liability, Waiver of Subrogation applies in favor of the additional insured, when agreed to by written contract or agreement.

All the above coverage is as required by written contract or agreement subject to the term and conditions of the policy.

Arizona Department of Environmental Quality 1110 W. Washington Street

Phoenix AZ 85007

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

INSURER(S) AFFORDING COVERAGE

INSURER F :

INSURER E :

INSURER D :

INSURER C :

INSURER B :

INSURER A :

NAIC #

NAME:

CONTACT

(A/C, No):

FAX

E-MAIL

ADDRESS:

PRODUCER

(A/C, No, Ext):

PHONE

INSURED

REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES

IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.

If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED

REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

OTHER:

(Per accident)

(Ea accident)

N / A

SUBR

WVD

ADDL

INSD

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.

$PROPERTY DAMAGE

BODILY INJURY (Per accident)

BODILY INJURY (Per person)

COMBINED SINGLE LIMIT

AUTOS ONLY

AUTOSAUTOS ONLY

NON-OWNED

SCHEDULEDOWNED

ANY AUTO

AUTOMOBILE LIABILITY

Y / N

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

OFFICER/MEMBER EXCLUDED?

(Mandatory in NH)

DESCRIPTION OF OPERATIONS below If yes, describe under

ANY PROPRIETOR/PARTNER/EXECUTIVE

E.L. DISEASE - POLICY LIMIT

E.L. DISEASE - EA EMPLOYEE

E.L. EACH ACCIDENT

ER

OTH-

STATUTE

PER

LIMITS(MM/DD/YYYY)

POLICY EXP

(MM/DD/YYYY)

POLICY EFF

POLICY NUMBERTYPE OF INSURANCELTR

INSR

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

EXCESS LIAB

UMBRELLA LIAB $EACH OCCURRENCE

$AGGREGATE

OCCUR

CLAIMS-MADE

DED RETENTION $

$PRODUCTS - COMP/OP AGG

$GENERAL AGGREGATE

$PERSONAL & ADV INJURY

$MED EXP (Any one person)

$EACH OCCURRENCE

DAMAGE TO RENTED

$PREMISES (Ea occurrence)

COMMERCIAL GENERAL LIABILITY

CLAIMS-MADE OCCUR

GEN'L AGGREGATE LIMIT APPLIES PER:

POLICY

PRO-

JECT LOC

CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)

CANCELLATION

AUTHORIZED REPRESENTATIVE

ACORD 25 (2016/03)

© 1988-2015 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER

The ACORD name and logo are registered marks of ACORD

HIRED

AUTOS ONLY

Matrix New World Engineering, Land Surveying and Landscape Architecture, P.United Assurance Inc

25 Certificate of Liability Insurance: Notes

EPLI and D&O Twin City Fire Ins. Co.

Policy: 13 KB 0372807-23 Effective Date: 3/1/2023 to 3/1/2024 Limit: $5,000,000

Valuable Papers - Hanover Ins. Co.

Policy : RHY5026707 Effective Date: 3/2/2023 to 3/2/2024 Blanket Limit: $1,000,000

Works Compensation - Nautilus Ins. Co.

Policy: WCA201734418 (Arizona Benefits) Effective Date: 3/2/2023 to 3/2/2024

NY Disability - GUARDIAN LIFE INS CO OF AMER Policy: 00932784-0000 Effective Date: 3/15/2022 to 3/15/2024 Statutory Limit

Cyber Liability - Houston Casualty Company Policy: H23NGP223097-00 Effective Date: 3/2/2023 to 3/2/2024 Limit: $5,000,000

ACORD 101 (2008/01)

The ACORD name and logo are registered marks of ACORD

© 2008 ACORD CORPORATION. All rights reserved.

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,

FORM NUMBER: FORM TITLE:

ADDITIONAL REMARKS

ADDITIONAL REMARKS SCHEDULE Page of

AGENCY CUSTOMER ID:

LOC #:

AGENCY

CARRIER NAIC CODE

POLICY NUMBER

NAMED INSURED

EFFECTIVE DATE:

00011183

3/2/2023

United Assurance Inc

ECP2017341-17 3/2/2023

Matrix New World Engineering, Land Surveying and Landscape Architecture, P.

Nautilus Insurance Company 17370

X

X

X ECP12460121 Additional Insured Blanket - ECP124801 21 A/I Completed Ops Blanket x x x x xno other option is available with this insurer No changes madeYes and

GL policy (including endorsements) does not cover the additional insured for claims involving injury to employees of the named insured or subcontractors (not workers' compensation)

I.

no other option is available with this insurer No changes madeYes and

"Insured contract" exception to the employers liability exclusion is removed or modified (GL policy)H.

no other option is available with this insurer No changes madeYes and

Blanket contractual liability located in the "insured contract" definition (Section V, Number 9, Item f. in the ISO CGL policy) is removed or restricted

G.

no other option is available with this insurerNo andYes

Additional insured will receive advance notice if insurer cancels (GL policy)F.

no other option is available with this insurerNo andYes

According to the terms of this GL policy, the additional insured has primary and noncontributory coverageE.

Title:#:

CG 20 38CG 20 37CG 20 33CG 20 32CG 20 26

Other:

CG 20 10

Additional insured endorsement (GL policy)D.

[see attached endorsement]

[see attached declarations / endorsement]

Designated work

Classifications

Building height:

Type of construction:

Location:

Specific operations excluded or restricted (GL policy)C.

Other

ISO / ISO modified

General Liability (GL) policy formB.

Excess line or free trade zone

Admitted / authorized

InsurerA.

Attach to ACORD 25ACORD 855 NY (2014/05) © 2014 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

REVISION NUMBER:CERTIFICATE NUMBER:ADDENDUM INFORMATION

EFFECTIVE DATE

NAMED INSURED(S)

POLICY NUMBER NAIC CODECARRIER

AGENCY

NEW YORK CONSTRUCTION

AGENCY CUSTOMER ID:

THIS ADDENDUM SUMMARIZES SOME OF THE POLICY PROVISIONS IN THE REFERENCED INSURANCE POLICIES AND IS ISSUED AS A MATTER OF INFORMATION ONLY; IT CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. ALL TERMS, EXCLUSIONS AND CONDITIONS IN THE ACTUAL POLICY SHOULD BE CONSULTED FOR A MORE DETAILED ANALYSIS OF COVERAGE, AS THIS ADDENDUM DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES.

CERTIFICATE OF LIABILITY INSURANCE ADDENDUM

DATE (MM/DD/YYYY)

INS855NY (201405)

00011183 x x x x

03/02/2023

DATE (MM/DD/YYYY)AUTHORIZED REPRESENTATIVE SIGNATURE

no other option is available with this insurerNo andYes, by endorsementYes, by specific policy provision

Excess / umbrella policy is primary and non-contributory for additional insuredsM.

no other option is available with this insurer No changes madeYes and

Property damage to work performed by subcontractors (exception to the "damage to your work" exclusion in the ISO CGL policy) is excluded or restricted

L.

no other option is available with this insurer No changes madeYes and

Insured vs. insured suits (cross liability in the ISO CGL policy) are excluded or restricted (other than named insured vs. named insured)K.

no other option is available with this insurer No changes madeYes and

Earth movement, excavation or explosion / collapse / underground property damage is excluded or restricted (GL policy)J.

ADDENDUM INFORMATION (continued) AGENCY CUSTOMER ID:

ACORD 855 NY (2014/05)

INS855NY (201405)

SCHEDULE OF FORMS AND ENDORSEMENTS

Policy Number: ECP2017341-17

Named Insured: Matrix New World Engineering, Land Surveying and Landscape Architecture, PC

FORMS ATTACHED TO AND MADE A PART OF THIS POLICY:

FORM NUMBER FORM TITLE

E001J 07 20 Nautilus Policy Jacket

ENV DIR CLAIMS 09 22 Policyholder Notice - Claim Reporting Information

ENV DEC 08 12 Common Policy Declarations

ECP SUPP DEC 01 21 Environmental Combined Policy Supplemental Declarations

ENV FORMS 09 10 Schedule of Forms and Endorsements

ECP 1200 03 22 Environmental Combined Policy Insuring Agreement

E906 (08-21) Service of Suit

BSUM-1200 (10-21) Contractual Liability Railroads - Automatic Status

BSUM-1200 (10-21) Waiver of Governmental Immunity

BSUM-1200 (10-21) Amendment of Cancellation Provisions – Advice of Cancellation to Other Parties

ECP 1207 01 21 Employee Benefits Liability

ECP 1214 02 21 Schedule of Insured Location(s)

ECP 1218 01 21 Project Specific Excess Limits of Insurance

ECP 1230 01 21 Watercraft

ECP 1230 01 21 Watercraft

ECP 1232 01 21 Earned Premium and Composite Rate - Not Subject to Premium Audit

ECP 1233 01 21 Named Insured Schedule

ECP 1234 10 21 Notice of Cancellation to Designated Person or Organization

ECP 1234 10 21 Notice of Cancellation to Designated Person or Organization

ECP 1234 10 21 Notice of Cancellation to Designated Person or Organization

ECP 1234 10 21 Notice of Cancellation to Designated Person or Organization

ECP 1234 10 21 Notice of Cancellation to Designated Person or Organization

ECP 1234 10 21 Notice of Cancellation to Designated Person or Organization

ECP 1234 10 21 Notice of Cancellation to Designated Person or Organization

ECP 1234 10 21 Notice of Cancellation to Designated Person or Organization

ECP 1234 10 21 Notice of Cancellation to Designated Person or Organization

ECP 1234 10 21 Notice of Cancellation to Designated Person or Organization

ECP 1234 10 21 Notice of Cancellation to Designated Person or Organization

ECP 1245 01 21 Additional Insured - State or Governmental Agency or Subdivision or Political Subdivision - Permits or Authorizations - Coverage A, B, D.1 & D.4

ECP 1246 01 21 Additional Insured - Owners, Lessees or Contractors - Automatic Status - Ongoing Operations - Coverage A, B, D.1 and D.4

ECP 1247 01 21 Additional Insured - Owners, Lessees or Contractors - Scheduled Person or Organization - Ongoing Operations - Coverage A, B, D.1 & D.4

ECP 1247 01 21 Additional Insured - Owners, Lessees or Contractors - Scheduled Person or Organization - Ongoing Operations - Coverage A, B, D.1 & D.4

ECP 1247 01 21 Additional Insured - Owners, Lessees or Contractors - Scheduled Person or Organization - Ongoing Operations - Coverage A, B, D.1 & D.4

ECP 1248 01 21 Additional Insured - Owners, Lessees or Contractors - Automatic Status - Completed Operations - Coverage A, D.1 & D.4

ECP 1249 01 21 Additional Insured - Owners, Lessees or Contractors - Scheduled Person or Organization - Completed Operations - Coverage A, D.1 & D.4

Page 1 of 2ENV FORMS 09 10

ECP 1249 01 21 Additional Insured - Owners, Lessees or Contractors - Scheduled Person or Organization - Completed Operations - Coverage A, D.1 & D.4

ECP 1249 01 21 Additional Insured - Owners, Lessees or Contractors - Scheduled Person or Organization - Completed Operations - Coverage A, D.1 & D.4

ECP 1249 01 21 Additional Insured - Owners, Lessees or Contractors - Scheduled Person or Organization - Completed Operations - Coverage A, D.1 & D.4

ECP 1249 01 21 Additional Insured - Owners, Lessees or Contractors - Scheduled Person or Organization - Completed Operations - Coverage A, D.1 & D.4

ECP 1249 01 21 Additional Insured - Owners, Lessees or Contractors - Scheduled Person or Organization - Completed Operations - Coverage A, D.1 & D.4

ECP 1249 01 21 Additional Insured - Owners, Lessees or Contractors - Scheduled Person or Organization - Completed Operations - Coverage A, D.1 & D.4

ECP 1249 01 21 Additional Insured - Owners, Lessees or Contractors - Scheduled Person or Organization - Completed Operations - Coverage A, D.1 & D.4

ECP 1249 01 21 Additional Insured - Owners, Lessees or Contractors - Scheduled Person or Organization - Completed Operations - Coverage A, D.1 & D.4

ECP 1249 01 21 Additional Insured - Owners, Lessees or Contractors - Scheduled Person or Organization - Completed Operations - Coverage A, D.1 & D.4

ECP 1249 01 21 Additional Insured - Owners, Lessees or Contractors - Scheduled Person or Organization - Completed Operations - Coverage A, D.1 & D.4

ECP 1257 01 21 Assumption of Claims Made Retroactive Date - Contractors Pollution Liability

ECP 1260 01 21 Waiver of Subrogation - Automatic Status - Coverage A, B & D

ECP 1261 01 21 Waiver of Subrogation - Designated Person(s) or Organization(s) - Coverage A & B

ECP 1261 01 21 Waiver of Subrogation - Designated Person(s) or Organization(s) - Coverage A & B

ECP 1261 01 21 Waiver of Subrogation - Designated Person(s) or Organization(s) - Coverage A & B

ECP 1261 01 21 Waiver of Subrogation - Designated Person(s) or Organization(s) - Coverage A & B

ECP 1261 01 21 Waiver of Subrogation - Designated Person(s) or Organization(s) - Coverage A & B

ECP 1261 01 21 Waiver of Subrogation - Designated Person(s) or Organization(s) - Coverage A & B

ECP 1261 01 21 Waiver of Subrogation - Designated Person(s) or Organization(s) - Coverage A & B

ECP 1261 01 21 Waiver of Subrogation - Designated Person(s) or Organization(s) - Coverage A & B

ECP 1272 01 21 Exclusion - Financial Services

ECP 1275 01 21 Exclusion of Certified Acts of Terrorism

ECP 1285 01 21 First Party Transportation Pollution Liability Coverage for Designated Vehicle(s)

ECP 1291 01 21 Microbial Substance Contractors Pollution Liability - Claims Made and Reported

ECP 1295 01 21 Designated Construction Project(s) General Aggregate Limit - Coverage A & D - Automatic Status

IL 12 02 01 16 Office of Foreign Asset Control (OFAC) Exclusion Endorsement

Page 2 of 2ENV FORMS 09 10

ECP 1295 01 21 Includes copyrighted material of Insurance Services Office, Inc., used with its permission. Page 1 of 2

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT –

COVERAGE A & D – AUTOMATIC STATUS

Policy Number Policy Effective Date Policy Expiration Date Endorsement Effective Date

ECP2017341-17 3/2/2023 3/2/2024 3/2/2023

This endorsement modifies insurance provided under the following:

ENVIRONMENTAL COMBINED POLICY

SECTION V – LIMITS OF INSURANCE is amended by the addition of the following terms and conditions when you have agreed in writing in a contract or agreement, in effect during this policy period, with any person or organization for whom you are performing operations, that a per-project aggregate will apply:

I. For all amounts which the insured becomes legally obligated to pay as damages caused by occurrences under SECTION I – COVERAGE A – BODILY INJURY AND PROPERTY DAMAGE LIABILITY and Coverage D.1 – Contractors Pollution Legal Liability and Coverage D.4 – Microbial Substance Contractors Pollution Liability which can be attributed only to covered operations at a single project:

1. A separate Per-Project Aggregate Limit applies to each project, and that limit is equal to the lesser of:

a. The applicable General Aggregate Limit; or

b. $2,000,000.

2. The Per-Project Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A – BODILY INJURY AND PROPERTY DAMAGE LIABILITY and Coverage D.1 – Contractors Pollution Legal Liability and Coverage D.4 – Microbial Substance Contractors Pollution Liability except damages because of bodily injury or property damage included in the products-completed operations hazard, regardless of the number of:

a. Insureds;

b. Claims made or suits brought; or

c. Persons or organizations making claims or bringing suits.

3. Any payments made under COVERAGE A – BODILY INJURY AND PROPERTY DAMAGE LIABILITY and Coverage D.1 – Contractors Pollution Legal Liability and Coverage D.4 – Microbial Substance Contractors Pollution Liability for damages shall reduce the Per-Project Aggregate Limit for that particular project. Such payments shall not reduce the applicable General Aggregate Limit nor shall they reduce any other Per-Project Aggregate Limit for any other project.

4. The applicable limits for Each Occurrence, Damage To Premises Rented To You continue to apply. However, instead of being subject to the applicable General Aggregate Limit, such limits will be subject to the applicable Per- Project Aggregate Limit.

5. Regardless of the number of projects covered under this policy, the most we will pay under the terms and conditions of this endorsement is $5,000,000.

II. For all amounts which the insured becomes legally obligated to pay as damages caused by occurrences under SECTION I – COVERAGE A – BODILY INJURY AND PROPERTY DAMAGE LIABILITY and Coverage D.1 – Contractors Pollution Legal Liability and Coverage D.4 – Microbial Substance Contractors Pollution Liability which cannot be attributed only to covered operations:

1. Any payments made under SECTION I –COVERAGE A – BODILY INJURY AND PROPERTY DAMAGE

LIABILITY and Coverage D.1 – Contractors Pollution Legal Liability and Coverage D.4 – Microbial Substance Contractors Pollution Liability for damages shall reduce the amount available under the General Aggregate Limit or the Products Completed Operations Aggregate Limit, whichever is applicable; and

2. Such payments shall not reduce any Per-Project Aggregate Limit.

III. When coverage for liability arising out of the products-completed operations hazard is provided, any payments for damages because of bodily injury or property damage included in the products-completed operations hazard will reduce the Products-Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Per- Project Aggregate Limit.

ECP 1295 01 21 Includes copyrighted material of Insurance Services Office, Inc., used with its permission. Page 2 of 2

IV. If the applicable project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the particular project will still be deemed to be the same project.

V. The provisions of SECTION V – LIMITS OF INSURANCE not otherwise modified by this endorsement shall continue to apply as stipulated.

VI. This endorsement does not apply to any Designated Construction Project(s) which has been specifically endorsed to this policy on a General Aggregate Limit endorsement showing the Designated Construction Project(s) in a SCHEDULE.

ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED.

ECP 1260 01 21 Includes copyrighted material of Insurance Services Office, Inc., used with its permission. Page 1 of 1

WAIVER OF SUBROGATION

(TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US)

AUTOMATIC STATUS – COVERAGE A, B & D

Policy Number Policy Effective Date Policy Expiration Date Endorsement Effective Date

ECP2017341-17 3/2/2023 3/2/2024 3/2/2023

This endorsement modifies insurance provided under the following:

ENVIRONMENTAL COMBINED POLICY

I. The following is added to Paragraph 17. Subrogation of SECTION VII – CONDITIONS:

We waive any right of recovery against any person(s) or organization(s) because of payments we make under COVERAGE A – BODILY INJURY AND PROPERTY DAMAGE LIABILITY, COVERAGE B – PERSONAL AND ADVERTISING INJURY LIABILITY, and COVERAGE D – CONTRACTORS POLLUTION LIABILITY under this policy.

Such waiver by us applies only if:

1. The insured has agreed in writing in a contract or agreement with such person(s) or organization(s) to waive its right of recovery; and

2. The insured has waived its right of recovery against such person(s) or organization(s) prior to loss.

This waiver does not apply in any jurisdiction where such waiver is held to be illegal or against public policy or in any situation where the person(s) or organization(s) against whom subrogation is to be waived is found to be solely negligent.

This endorsement does not apply to any person(s) or organization(s) designated in a SCHEDULE of person(s) or organization(s) against whom rights of recovery have been waived.

ECP 1248 01 21 Includes copyrighted material of Insurance Services Office, Inc., used with its permission. Page 1 of 2

ADDITIONAL INSURED -- OWNERS, LESSEES OR CONTRACTORS

AUTOMATIC STATUS – COMPLETED OPERATIONS – COVERAGE A, D.1 & D.4

Policy Number Policy Effective Date Policy Expiration Date Endorsement Effective Date

ECP2017341-17 3/2/2023 3/2/2024 3/2/2023

This endorsement modifies insurance provided under the following:

ENVIRONMENTAL COMBINED POLICY

I. SECTION III – WHO IS AN INSURED is amended to include as an additional insured:

1. Any person or organization for whom you have performed operations when you and such person or organization have agreed in writing in a contract or agreement, in effect during this policy period, that such person or organization be added as an additional insured on this policy; and

2. Any other person or organization you are explicitly required to add as an additional insured under the contract or agreement described in Paragraph 1. above.

Such contract or agreement must be executed and in effect prior to the performance of your work included in the products-completed operations hazard which is the subject of such contract or agreement.

Such person(s) or organization(s) is an additional insured only with respect to liability for bodily injury or property damage under SECTION I – COVERAGE A – BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Coverage D.1 – Contractors Pollution Legal Liability and Coverage D.4 – Microbial Substance Contractors Pollution Liability, directly caused by your work performed for the additional insured described in Paragraph 1.

or 2. above, and included in the products-completed operations hazard.

However, the insurance afforded to such additional insured described above:

a. Only applies to the extent permitted by law; and

b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured; and

c. Will not extend beyond that which is provided to you in this policy.

II. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:

This insurance does not apply to:

a. Bodily injury or property damage arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including:

(1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or

(2) Supervisory, inspection, architectural or engineering activities.

This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the occurrence which caused the bodily injury or property damage involved the rendering of, or the failure to render any professional architectural, engineering or surveying services.

III. With respect to the insurance afforded to these additional insureds, the following is added to SECTION V – LIMITS

OF INSURANCE:

The most we will pay on behalf of the additional insured is the amount of insurance:

1. Required by the contract or agreement described in Paragraph I.1.; or

2. Available under the applicable limits of insurance;

whichever is less.

This endorsement shall not increase the applicable limits of insurance.

IV. With respect to the insurance afforded to these additional insureds, the following is added to SECTION VI –

ECP 1248 01 21 Includes copyrighted material of Insurance Services Office, Inc., used with its permission. Page 2 of 2

REPORTING, DEFENSE, SETTLEMENT & COOPERATION:

1. Duties -- Additional Insured An additional insured must see to it that:

a. We are notified in writing as soon as practicable of an occurrence which may result in a claim or suit;

b. We receive written notice of a claim or suit as soon as practicable; and

c. A request for defense and indemnity of the claim or suit will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured, if the contract or agreement requires that this coverage be primary and noncontributory.

V. SECTION VII – CONDITION 10. – Other Insurance is amended by the addition of the following which supersedes any provision to the contrary:

Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to a person(s) or organization(s) included as an additional insured under this endorsement provided that:

1. The additional insured person(s) or organization(s) is a Named Insured under such other insurance; and

2. You have agreed in writing in a contract or agreement, in effect during this policy period, that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured person(s) or organization(s). Such contract or agreement must be executed and in effect prior to the performance of your work included in the products-completed operations hazard which is the subject of such contract or agreement.

However, this provision does not apply if the other insurance available to the person(s) or organization(s) included as an additional insured is Owners and Contractors Protective Liability, Railroad Protective Liability, or similar project-specific, primary insurance.

VI. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement showing the additional insured in a SCHEDULE of additional insureds, and which endorsement applies to that designated additional insured.

ECP 1246 01 21 Includes copyrighted material of Insurance Services Office, Inc., used with its permission. Page 1 of 2

ADDITIONAL INSURED -- OWNERS, LESSEES OR CONTRACTORS

AUTOMATIC STATUS – ONGOING OPERATIONS – COVERAGE A, B, D.1 & D.4

Policy Number Policy Effective Date Policy Expiration Date Endorsement Effective Date

ECP2017341-17 3/2/2023 3/2/2024 3/2/2023

This endorsement modifies insurance provided under the following:

ENVIRONMENTAL COMBINED POLICY

I. SECTION III – WHO IS AN INSURED is amended to include as an additional insured:

1. Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement, in effect during this policy period, that such person or organization be added as an additional insured on this policy; and

2. Any other person or organization you are explicitly required to add as an additional insured under the contract or agreement described in Paragraph 1. above.

Such contract or agreement must be executed and in effect prior to the performance of your work which is the subject of such contract or agreement.

Such person(s) or organization(s) is an additional insured only with respect to liability for bodily injury or property damage under SECTION I – COVERAGE A – BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Coverage D.1 – Contractors Pollution Legal Liability and Coverage D.4 – Microbial Substance Contractors Pollution Liability, or personal injury or advertising injury under SECTION I - COVERAGE B – PERSONAL AND ADVERTISING INJURY LIABILITY directly caused by:

a. Your acts or omissions; or

b. The acts or omissions of those acting on your behalf;

in the performance of your ongoing operations for the additional insured described in Paragraph 1. or 2. above.

However, the insurance afforded to such additional insured described above:

a. Only applies to the extent permitted by law; and

b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured, and

c. Will not extend beyond that which is provided to you in this policy.

A person’s or organization’s status as an additional insured under this endorsement ends when your operations for the person or organization described in Paragraph 1. above are completed.

II. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:

This insurance does not apply to:

a. Bodily injury, property damage or personal and advertising injury arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including:

(1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or

(2) Supervisory, inspection, architectural or engineering activities.

This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the occurrence which caused the bodily injury or property damage, or the offense which caused the personal and advertising injury, involved the rendering of, or the failure to render any professional architectural, engineering or surveying services.

b. Bodily injury or property damage occurring after:

(1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or

ECP 1246 01 21 Includes copyrighted material of Insurance Services Office, Inc., used with its permission. Page 2 of 2

(2) That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project.

III. With respect to the insurance afforded to these additional insureds, the following is added to SECTION V – LIMITS

OF INSURANCE:

The most we will pay on behalf of the additional insured is the amount of insurance:

1. Required by the contract or agreement described in Paragraph I.1.; or

2. Available under the applicable limits of insurance;

whichever is less.

This endorsement shall not increase the applicable limits of insurance.

IV. With respect to the insurance afforded to these additional insureds, the following is added to SECTION VI –

REPORTING, DEFENSE, SETTLEMENT & COOPERATION:

1. Duties -- Additional Insured An additional insured must see to it that:

a. We are notified in writing as soon as practicable of an occurrence or offense which may result in a claim or suit;

b. We receive written notice of a claim or suit as soon as practicable; and

c. A request for defense and indemnity of the claim or suit will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured, if the contract or agreement requires that this coverage be primary and noncontributory.

V. SECTION VII – CONDITION 10. – Other Insurance is amended by the addition of the following which supersedes any provision to the contrary:

Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to a person(s) or organization(s) included as an additional insured under this endorsement provided that:

1. The additional insured person(s) or organization(s) is a Named Insured under such other insurance; and

2. You have agreed in writing in a contract or agreement, in effect during this policy period, that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured person(s) or organization(s). Such contract or agreement must be executed and in effect prior to the performance of your work which is the subject of such contract or agreement.

However, this provision does not apply if the other insurance available to the person(s) or organization(s) included as an additional insured is Owners and Contractors Protective Liability, Railroad Protective Liability, or similar project-specific, primary insurance.

VI. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement showing the additional insured in a SCHEDULE of additional insureds, and which endorsement applies to that designated additional insured.

BSUM-1200 (10-21) Page 1 of 1

POLICY CHANGES

POLICY CHANGE NUMBER:

POLICY NUMBER

ECP2017341-17

POLICY CHANGES EFFECTIVE

3/2/2023

COMPANY

Nautilus Insurance Company

NAMED INSURED

Matrix New World Engineering, Land Surveying and Landscape Architecture, PC

26 Columbia Tpke

Florham Park, NJ 07932

AUTHORIZED REPRESENTATIVE

COVERAGE PARTS AFFECTED:

Environmental Combined Policy

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

Waiver of Governmental Immunity

In consideration of the premium charged and notwithstanding anything contained in this policy to the contrary, it is hereby agreed and understood thatthe following changes shall apply to the policy: The insurer(s) shall not, without obtaining the express advance written permission from the General Counsel of the Port Authority, raise any defense involving in any way the jurisdiction of the Tribunal over the person of the Port Authority, the immunity of the Port Authority, its Commissioners, officers, agents, or employees, the governmental nature of the Port Authority, or the provisions of any statutes respecting suits against the Port Authority.

All other terms and conditions remain unchanged.

BSUM-1200 (10-21) Page 1 of 1

POLICY CHANGES

POLICY CHANGE NUMBER:

POLICY NUMBER

ECP2017341-17

POLICY CHANGES EFFECTIVE

3/2/2023

COMPANY

Nautilus Insurance Company

NAMED INSURED

Matrix New World Engineering, Land Surveying and Landscape Architecture, PC

26 Columbia Tpke

Florham Park, NJ 07932

AUTHORIZED REPRESENTATIVE

COVERAGE PARTS AFFECTED:

manually attach

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

Contractual Liability Railroads - Automatic Status manually attach

All other terms and conditions remain unchanged.

NAUTILUS INSURANCE COMPANY

Scottsdale, Arizona

FOLLOW FORM EXCESS LIABILITY COVERAGE FORM DECLARATIONS

POLICY NUMBER: FFX2017342-17 RENEWAL OF: FFX2017342-16

INSURED’S NAME AND ADDRESS: PRODUCER’S NAME AND ADDRESS:

Matrix New World Engineering, Land Surveying and Landscape Architecture, PC 26 Columbia Tpke Florham Park, NJ 07932

United Assurance Inc.

16-00 Pollitt Dr Fair Lawn, NJ 07410

POLICY PERIOD: March 02, 2023 to March 02, 2024 at 12:01 a.m. Standard Time at your mailing address shown above.

IN RETURN FOR THE PAYMENT OF PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU

TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY.

FORM OF BUSINESS:

Corporation

NOTICE TO THE INSURED:

This Insurance is Issued Pursuant to the New Jersey Surplus Lines Law.

Notice to Policyholder:

This policy is written by a surplus lines insurer, and is not subject to the rate or form filing or approval requirements of the New Jersey Department of Banking and Insurance. Such a policy may contain conditions, limitations, exclusions and different terms than a policy issued by an insurer granted a Certificate of Authority by the New Jersey Department of Banking and Insurance. The insurer has been approved by the Department as an eligible surplus lines insurer, but the policy is not covered by the New Jersey Guarantee Association, and only a policy of medical malpractice liability insurance as defined in N.J.S.A. 17:3OD-3d or a policy of property insurance covering owner-occupied dwellings of less than four dwelling units are covered by the New Jersey Surplus Lines Guaranty Fund.

LIMITS OF INSURANCE:

EACH OCCURRENCE $ 10,000,000

POLICY AGGREGATE $ 10,000,000

NAME AND ADDRESS OF ADMINISTRATIVE OFFICE:

Berkley Environmental (A Berkley Company) Two Ravinia Drive, Suite 1100, Atlanta, GA 30346 Phone No.: (404) 443-2040, See CLAIMS NOTICE for claims contact information.

THIS COMMON POLICY DECLARATION AND THE SUPPLEMENTAL DECLARATION(S) TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE PART COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS, IF ANY, ISSUED TO

FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY.

Issue Date: 03/01/2023

SCHEDULE OF CONTROLLING UNDERLYING INSURANCE:

SEE SCHEDULE OF CONTROLLING UNDERLYING INSURANCE

FORMS AND ENDORSEMENTS (Other than applicable forms and endorsements shown elsewhere in the policy):

Forms and Endorsements applying to this policy and made part of this policy at time of issue:

SEE SCHEDULE OF FORMS AND ENDORSEMENTS

PREMIUM

FOLLOW FORM EXCESS LIABILITY COVERAGE FORM: $

TERRORISM RISK INSURANCE ACT:

POLICY PREMIUM: $

Page 1 of 1FFX DEC 07 18

SCHEDULE OF FORMS AND ENDORSEMENTS

Policy Number: FFX2017342-17

Named Insured: Matrix New World Engineering, Land Surveying and Landscape Architecture, PC

FORMS ATTACHED TO AND MADE A PART OF THIS POLICY:

FORM NUMBER FORM TITLE

E001J 07 20 Nautilus Policy Jacket

ENV DIR CLAIMS 09 22 Policyholder Notice - Claim Reporting Information

FFX DEC 07 18 Follow Form Excess Liability Coverage Form Declarations

ENV FORMS 09 10 Schedule of Forms and Endorsements

FFX 8000 02 22 Follow Form Excess Liability Coverage Form

E906 (08-21) Service of Suit

ENV 2216 11 16 Named Insured Endorsement

FFX 8002 07 18 Follow Form Excess Liability Coverage Form Schedule of Controlling Underlying Insurance

FFX 8011 08 18 Noncontributory - Other Insurance Condition

FFX 8029 07 18 Microbial Substance Exclusion

FFX 8059 02 21 Earned Premium and Composite Rate - Not Subject to Premium Audit

ENV 2225 10 18 Exclusion of Certified Acts of Terrorism

IL 12 02 01 16 Office of Foreign Asset Control (OFAC) Exclusion Endorsement

Page 1 of 1ENV FORMS 09 10

FOLLOW FORM EXCESS LIABILITY COVERAGE FORM

SCHEDULE OF CONTROLLING UNDERLYING INSURANCE

Policy Number: FFX2017342-17

UNDERLYING

POLICY TYPE LIMITS OF INSURANCE POLICY

PERIOD

CARRIER &

POLICY NUMBER

Commercial Automobile $ 1,000,000 Liability - Combined Single Limit

03/02/2023 to

03/02/2024

Hanover Insurance Group

AWY-7938199

Employer’s Liability – Coverage B

$ 1,000,000 BI by Accident - Each Accident Limit

$ 1,000,000 BI by Disease - Each Employee Limit

$ 1,000,000 BI by Disease - Policy Aggregate Limit

03/02/2023 to

03/02/2024

Nautilus Insurance Company

WCA2017344-18

Employer’s Liability – Coverage B

$ 1,000,000 BI by Disease - Policy Aggregate Limit

$ 1,000,000 BI by Disease - Each Employee Limit

$ 1,000,000 BI by Accident - Each Accident Limit

03/02/2023 to

03/02/2024

Great Divide Insurance Company

WCA2017343-18

General Liability $ 2,000,000 Personal & Advertising Injury Limit

$ 2,000,000 Products/Completed Operations Aggregate Limit

$ 2,000,000 General Aggregate Limit (Other than Products/Completed Operations)

$ 1,000,000 Employee Benefit Liability – Each Employee Limit

$ 2,000,000 Each Occurrence Limit

$ 1,000,000 Employee Benefit Liability – Aggregate Limit

03/02/2023 to

03/02/2024

Nautilus Insurance Company

ECP2017341-17

Pollution/Professional $ 2,000,000 Contractors Pollution Liability Limit

$ 2,000,000 Professional Liability Limit

03/02/2023 to

03/02/2024

Nautilus Insurance Company

ECP2017341-17

The coverages and limits shown above are provided by the policy(ies) of controlling underlying insurance.

Page 1 of 1FFX 8002 07 18

FFX 8011 08 18 Page 1 of 1

ENDORSEMENT

This endorsement forms a part of the policy to which it is attached. Please read it carefully.

NONCONTRIBUTORY – OTHER INSURANCE CONDITION

This endorsement modifies insurance provided under the following:

FOLLOW FORM EXCESS LIABILITY COVERAGE FORM

SCHEDULE

Name Of Additional Insured Person(s) Or Organization(s):

Blanket Where Required by Written Contract or Agreement

Paragraph 8. Of Section III – Conditions is deleted and replaced by the following:

8. Other Insurance

a. This insurance is excess over, and shall not contribute with any of the other insurance, whether primary, excess, contingent or on any other basis. However:

(1) This condition will not apply to other insurance specifically written as excess over this Coverage Form.

(2) The insurance provided under this Coverage Form will not seek contribution from any other insurance available to an additional insured, provided that:

(a) The additional insured is a Named Insured under such insurance;

(b) The additional insured is shown in the Schedule; and

(c) You have agreed in writing in a contract or agreement that this insurance would not seek contribution from any other insurance available to the additional insured.

When this insurance is excess, if no other insurer defends, we will undertake to do so, but we will be entitled to the insured’s rights against all those other insurers.

b. When this insurance is excess over other insurance, we will pay only our share of the ultimate net loss that exceeds:

(1) The total amount that all such other insurance would pay for the loss in the absence of the insurance provided under this Coverage Form; plus

(2) The total of all deductible and self-insured amounts under all that other insurance.

WORKERS COMPENSATION AND EMPLOYERS

LIABILITY INSURANCE POLICY

RENEWAL

INFORMATION PAGE NCCI Carrier Code Number: 34681

Issuing Company:PolicyNumber: WCA2017343-18 Previous Policy: WCA2017343-17 Great Divide Insurance Company

A Berkley Insurance Company 7233 E. Butherus Dr Scottsdale, AZ 85260

1. Name Insured and Address Agency Name and Address 29313 Matrix New World Engineering, Land Surveying and Landscape Architecture, PC 26 Columbia Tpke Florham Park, NJ 07932

Other workplaces not shown above:

Refer to Name and Location Schedule

201-254-1802 United Assurance Inc.

16-00 Pollitt Dr Fair Lawn, NJ 07410

FEIN: 223057511 UIAN: Risk ID Number: 913426118 Bureau File Number: 046909

State: NJ Entity of Insured: Corp./LLC

2. The Policy Period is from 03/02/2023to 03/02/2024 12:01 AM Standard Time at the insured's mailing address.

3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: NJ AK AL CA CT FL LA MA MD MS NH NM NY TX

B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part Two are:

Bodily Injury by Accident $ 1,000,000 each accident Bodily Injury by Disease $ 1,000,000 policy limit Bodily Injury by Disease $ 1,000,000 each employee

C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here:

All states except AZ, ND, OH, WA, WY and states designated in item 3.A. of the information page.

D. This policy includes these endorsements and schedules: See "Schedule of Forms and Endorsements"

WC 00 00 01 A © Copyright 1987 National Council on Compensation Insurance, Inc. All Rights Reserved Page 1 of 2

POLICY PERIOD

COVERAGE

j.fugate Highlight

WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY

WC 04 03 06 04 84

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA_WC 04 03 06_04/84

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS

ENDORSEMENT - CALIFORNIA

We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.)

You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule.

The additional premium for this endorsement shall be 0.00% of the California workers' compensation premium otherwise due on such remuneration.

Schedule

Person or Organization

Any person or organization as required in writing by contract or agreement prior to loss.

This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.

(The information below is required only when this endorsement is issued subsequent to preparation of the policy)

Endorsement Effective 03/02/2022 Insured Matrix New World Engineering, Land Surveying and Landscape Architecture, PC

Policy No.

WCA2017343 17

Endorsement No.

Premium

Insurance Company: Countersigned by

Great Divide Insurance Company

WC 04 03 06 04 84 1998 by the Workers' Compensation Insurance Rating Bureau of California. Page 1 of 1 All rights reserved. From the WCIRB's California Workers' Compensation

Insurance Forms Manual 2001.

WC 00 03 13 04 84

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT_WC 00 03 13_04/84

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS

ENDORSEMENT

We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.)

This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.

Schedule

Blanket Where Required by Written Contract Agreement

WC 00 03 13 04 84 © 1983 National Council on Compensation Insurance Page 1 of 1

WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 02 01 B (01 15)

MARITIME COVERAGE ENDORSEMENT_WC 00 02 01 A_04/92

MARITIME COVERAGE ENDORSEMENT

This endorsement changes how insurance provided by Part Two (Employers Liability Insurance) applies to bodily injury to a master or member of the crew of any vessel.

A. How This Insurance Applies is replaced by the following:

A. How This Insurance Applies

This insurance applies to bodily injury by accident or bodily injury by disease. Bodily injury includes resulting death.

1. The bodily injury must arise out of and in the course of the injured employee's employment by you.

2. The employment must be necessary or incidental to work described in Item 1 of the Schedule of the Maritime

Coverage Endorsement.

3. The bodily injury must occur in the territorial limits of, or in the operation of a vessel sailing directly between the ports of, the continental United States of America, Alaska, Hawaii or Canada.

4. Bodily injury by accident must occur during the policy period.

5. Bodily injury by disease must be caused or aggravated by the conditions of your employment. The employee's last day of last exposure to the conditions causing or aggravating such bodily injury by disease must occur during the policy period.

6. If you are sued, the original suit and any related legal actions for damages for bodily injury by accident or by disease must be brought in the United States of America, its territories or possessions, or Canada.

C. Exclusions is changed by removing exclusion 10 and by adding exclusions 13 and 14.

This insurance does not cover:

13. Bodily injury covered by a Protection and Indemnity Policy or similar policy issued to you or for your benefit.

This exclusion applies even if the other policy does not apply because of another insurance clause, deductible or limitation of liability clause, or any similar clause.

14. Your duty or obligation to provide transportation, wages, maintenance, and cure. This exclusion does not apply if a premium entry is shown in Item 2 of the Schedule, except that punitive damages related to your duty or obligation to provide transportation, wages, maintenance, and cure under any applicable maritime law are excluded even if a premium is paid for transportation, wages, maintenance, and cure coverage.

D. We Will Defend is changed by adding the following statement:

We will treat a suit or other action in rem against a vessel owned or chartered by you as a suit against you.

G. Limits of Liability Our liability to pay for damages is limited. Our limits of liability are shown in the Schedule. They apply as explained below.

1. Bodily Injury by Accident. The limit shown for "bodily injury by accident-each accident" is the most we will pay for all damages covered by this insurance because of bodily injury to one or more employees in any one accident.

A disease is not bodily injury by accident unless it results directly from bodily injury by accident.

2. Bodily Injury by Disease. The limit shown for "bodily injury by disease-aggregate" is the most we will pay for all damages covered by this insurance because of bodily injury by disease to one or more employees. The limit applies separately to bodily injury by disease arising out of work in each state shown in Item 3.A. of the Information Page. Bodily injury by disease will be deemed to occur in the state of the vessel's home port.

Bodily injury by disease does not include disease that results directly from a bodily injury by accident.

3. We will not pay any claims for damages after we have paid the applicable limit of our liability under this insurance.

WC 00 02 01 B (01 15) © 1983-2013 National Council on Compensation Insurance, Inc. All Rights Reserved Page 1 of 2

WC 00 02 01 B (01 15) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY

Schedule

1. Description of work: If any

2. Transportation, Wages, Maintenance and Cure Premium $ 0 Exclusion: This insurance does not cover punitive damages related to your duty or obligation to provide transportation, wages, maintenance, and…