This endorsement, effective ___________, forms part of Policy No. E16-8154-003 issued to EFFECTIVE FROM INCEPTION DATE OF POLICY by the insurance company indicated below by an "X".

THE EMPLOYERS' LIABILITY ASSURANCE CORPORATION, LTD. ☐ AMERICAN EMPLOYERS' INSURANCE COMPANY ☐ THE EMPLOYERS' FIRE INSURANCE COMPANY ☐ THE NORTHERN ASSURANCE COMPANY OF AMERICA

It is agreed that the total liability of the Company, under Policy E16-8154-004 and this policy shall in no event exceed the Company's limit of liability of $3,000,000.00 as stated in the Proportion of Risk Insured of the policy.

Countersigned / J.V. Chalmers
Authorized Representative
End. #1