Bakersfield City Council
October 21, 2026

AMENDMENT TO AGREEMENT NO. 2023-248
C:\Users\docusign\AppData\Local\Temp\ABCpdf\1d9de17a-572d-4c3d-a047-823230ddc2ed.docx -- Page 1 of 2 Pages --
AGREEMENT NO. 2023-248(1)
AMENDMENT NO. (1) TO
AGREEMENT NO. 2023-248
This AMENDMENT NO. 1 TO AGREEMENT NO. 2023-248 is made and entered into on ________________, by and between the CITY OF BAKERSFIELD, a municipal corporation (referred to herein as “CITY”), and SUMMIT STRATEGIES GOVERNMENT AFFAIRS, LLC a limited liability company authorized to do business in California (referred to herein as “CONTRACTOR”).

R E C I T A L S
WHEREAS, on October 25, 2023, CITY and CONTRACTOR entered into Agreement No. 2023-248 to administer and advocate for the City’s Federal Legislative and Funding Platform; and
WHEREAS, the parties desire to amend Agreement No. 2023-248 to extend the term of the agreement and increase compensation by FIFTY-SEVEN THOUSAND DOLLARS ($57,000) for a new total compensation amount not to exceed THREE HUNDRED AND SIX THOUSAND DOLLARS ($306,000).

NOW, THEREFORE, incorporating the foregoing recitals herein, CITY and CONTRACTOR mutually agree as follows:

1. Section 2 of Agreement No. 2023-248 entitled “COMPENSATION/ PAYMENT PROCEDURE” is hereby amended to read as follows:

2. COMPENSATION/PAYMENT PROCEDURE. Subject to the
conditions of this section, CITY will pay CONTRACTOR as follows for performing the Scope of Work (“Compensation”):
(1) A monthly amount of Six Thousand Five Hundred Dollars ($6,500) for performing the scope of work and services; and (2) An annual amount not to exceed $5,000 for reasonable costs incurred by CONTRACTOR and travel to CITY in
performing the scope of services.

CITY will pay CONTRATOR within 30 days after CONTRACTOR submits an itemized invoice for the portions of the Scope of Work completed and that invoice is approved by CITY. The Docusign Envelope ID: 38BE8C24-9A4C-8461-83AE-5875AAFEF917 AMENDMENT TO AGREEMENT NO. 2023-248
C:\Users\docusign\AppData\Local\Temp\ABCpdf\1d9de17a-572d-4c3d-a047-823230ddc2ed.docx -- Page 2 of 2 Pages --
Compensation will be the total amount paid to CONTRACTOR for performing the Scope of Work and includes, but is not limited to, all out-of-pocket costs and taxes. CITY will pay no other compensation to CONTRACTOR. In no case will CITY
compensate CONTRACTOR more than Three Hundred Six
Thousand Dollars ($306,000) for performing the Scope of Work.

2. Section 3 of Agreement No. 2023-248 entitled “TERM” is hereby amended to read as follows:

3. TERM. Unless terminated sooner, as set forth herein, this Agreement shall terminate on June 30, 2027.

3. Except as amended herein, all provisions of Agreement No. 2023-248 shall remain in full force and effect.
-- o0o –
IN WITNESS WHEREOF, the parties hereto have caused this Amendment No. 1 to Agreement No. 2023-248 to be executed the day and year first above written. “CITY” “CONTRACTOR”

CITY OF BAKERSFIELD SUMMIT STRATEGIES

GOVERNMENT AFFAIRS, LLC
By:____________________________ By:_________________________________

KAREN GOH
Mayor Print Name: ________________________
Title:___________________________
APPROVED AS TO CONTENT:

CITY MANAGER’S OFFICE
By:____________________________

CHRISTIAN CLEGG

CITY MANAGER
APPROVED AS TO FORM: COUNTERSIGNED:
(Deputy) City Attorney:_______________________ Finance Director: _____________________

VIRGINIA GENNARO RANDY MCKEEGAN
Insurance:____________
Docusign Envelope ID: 38BE8C24-9A4C-8461-83AE-5875AAFEF917 Mark Dedrick
Partner
Certificate Of Completion
Envelope Id: 38BE8C24-9A4C-8461-83AE-5875AAFEF917 Status: Completed Subject: Complete with Docusign: SummitStrategies-Amend1.Agr2023-248.docx Source Envelope:

Document Pages: 2 Signatures: 2 Envelope Originator:

Certificate Pages: 5 Initials: 0 City Clerk's Office
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
[email protected]
IP Address: 174.46.226.5
Record Tracking
Status: Original
10/12/2026 5:03:18 PM
Holder: City Clerk's Office
[email protected]
Location: DocuSign
Security Appliance Status: Connected Pool: StateLocal
Signer Events Signature Timestamp
Mark Dedrick
[email protected]
Partner
Security Level: Email, Account Authentication
(None) Signature Adoption: Pre-selected Style
Using IP Address: 4.38.191.66
Sent: 10/12/2026 5:05:02 PM
Resent: 10/13/2026 3:56:51 PM
Viewed: 10/13/2026 4:04:38 PM
Signed: 10/13/2026 4:05:16 PM
Electronic Record and Signature Disclosure:

Accepted: 10/13/2026 4:04:38 PM
ID: 4dd126b2-5f67-412b-8367-be5c3dfe83b2
Christian Clegg
[email protected]
City Manager
City of Bakersfield
Security Level: Email, Account Authentication
(None)
Signature Adoption: Drawn on Device
Using IP Address:
2603:9008:3640:5985:9c9f:1b00:5235:5949
Signed using mobile
Sent: 10/13/2026 4:05:17 PM
Viewed: 10/14/2026 9:30:03 AM
Signed: 10/14/2026 9:30:45 AM
Electronic Record and Signature Disclosure:

Accepted: 10/14/2026 9:30:03 AM
ID: 12e7980e-74d4-4cde-84bc-1cf5905b8cce
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 10/12/2026 5:05:02 PM
Envelope Summary Events Status Timestamps
Certified Delivered Security Checked 10/14/2026 9:30:03 AM Signing Complete Security Checked 10/14/2026 9:30:45 AM Completed Security Checked 10/14/2026 9:30:45 AM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure

ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, City of Bakersfield (we, us or Company) may be required by law to provide to you certain written notices or disclosures. Described below are the terms and conditions for providing to you such notices and disclosures electronically through the DocuSign system.

Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to this Electronic Record and Signature Disclosure (ERSD), please confirm your agreement by selecting the check-box next to ‘I agree to use electronic records and signatures’ before clicking ‘CONTINUE’ within the DocuSign system.

Getting paper copies
At any time, you may request from us a paper copy of any record provided or made available electronically to you by us. You will have the ability to download and print documents we send to you through the DocuSign system during and immediately after the signing session and, if you elect to create a DocuSign account, you may access the documents for a limited period of time (usually 30 days) after such documents are first sent to you. After such time, if you wish for us to send you paper copies of any such documents from our office to you, you will be charged a $0.00 per-page fee. You may request delivery of such paper copies from us by following the procedure described below.

Withdrawing your consent
If you decide to receive notices and disclosures from us electronically, you may at any time change your mind and tell us that thereafter you want to receive required notices and disclosures only in paper format. How you must inform us of your decision to receive future notices and disclosure in paper format and withdraw your consent to receive notices and disclosures electronically is described below.

Consequences of changing your mind
If you elect to receive required notices and disclosures only in paper format, it will slow the speed at which we can complete certain steps in transactions with you and delivering services to you because we will need first to send the required notices or disclosures to you in paper format, and then wait until we receive back from you your acknowledgment of your receipt of such paper notices or disclosures. Further, you will no longer be able to use the DocuSign system to receive required notices and consents electronically from us or to sign electronically documents from us.

All notices and disclosures will be sent to you electronically Electronic Record and Signature Disclosure created on: 6/28/2022 10:51:05 AM Parties agreed to: Mark Dedrick, Christian Clegg
Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you through the DocuSign system all required notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you during the course of our relationship with you. To reduce the chance of you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required notices and disclosures to you by the same method and to the same address that you have given us. Thus, you can receive all the disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agree with this process, please let us know as described below. Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures electronically from us.

How to contact City of Bakersfield:

You may contact us to let us know of your changes as to how we may contact you electronically, to request paper copies of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as follows:

To contact us by email send messages to: [email protected] To advise City of Bakersfield of your new email address To let us know of a change in your email address where we should send notices and disclosures electronically to you, you must send an email message to us at [email protected] and in the body of such request you must state: your previous email address, your new email address. We do not require any other information from you to change your email address.

If you created a DocuSign account, you may update it with your new email address through your account preferences.

To request paper copies from City of Bakersfield
To request delivery from us of paper copies of the notices and disclosures previously provided by us to you electronically, you must send us an email to [email protected] and in the body of such request you must state your email address, full name, mailing address, and telephone number. We will bill you for any fees at that time, if any.

To withdraw your consent with City of Bakersfield
To inform us that you no longer wish to receive future notices and disclosures in electronic format you may:
i. decline to sign a document from within your signing session, and on the subsequent page, select the check-box indicating you wish to withdraw your consent, or you may; ii. send us an email to [email protected] and in the body of such request you must state your email, full name, mailing address, and telephone number. We do not need any other information from you to withdraw consent.. The consequences of your withdrawing consent for online documents will be that transactions may take a longer time to process..

Required hardware and software
The minimum system requirements for using the DocuSign system may change over time. The current system requirements are found here: https://support.docusign.com/guides/signer-guidesigning-system-requirements.

Acknowledging your access and consent to receive and sign documents electronically To confirm to us that you can access this information electronically, which will be similar to other electronic notices and disclosures that we will provide to you, please confirm that you have read this ERSD, and (i) that you are able to print on paper or electronically save this ERSD for your future reference and access; or (ii) that you are able to email this ERSD to an email address where you will be able to print on paper or save it for your future reference and access. Further, if you consent to receiving notices and disclosures exclusively in electronic format as described herein, then select the check-box next to ‘I agree to use electronic records and signatures’ before clicking ‘CONTINUE’ within the DocuSign system.

By selecting the check-box next to ‘I agree to use electronic records and signatures’, you confirm that:
 You can access and read this Electronic Record and Signature Disclosure; and  You can print on paper this Electronic Record and Signature Disclosure, or save or send this Electronic Record and Disclosure to a location where you can print it, for future reference and access; and
 Until or unless you notify City of Bakersfield as described above, you consent to receive exclusively through electronic means all notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you by City of Bakersfield during the course of your relationship with City of Bakersfield.

ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED?

INSR ADDL SUBR

LTR INSD WVD
PRODUCER CONTACT NAME: PHONE FAX
(A/C, No, Ext): (A/C, No): E-MAIL ADDRESS:

INSURER A :

INSURED INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :

POLICY NUMBER POLICY EFF POLICY EXP TYPE OF INSURANCE (MM/DD/YYYY) (MM/DD/YYYY) LIMITS

AUTOMOBILE LIABILITY

UMBRELLA LIAB

EXCESS LIAB WORKERS COMPENSATION

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

AUTHORIZED REPRESENTATIVE
EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- POLICY JECT LOC PRODUCTS - COMP/OP AGG OTHER: $ COMBINED SINGLE LIMIT
(Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $
$ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH- STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $
If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT INSURER(S) AFFORDING COVERAGE NAIC #

COMMERCIAL GENERAL LIABILITY
Y / N
N / A
(Mandatory in NH)

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.

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.

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.

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).

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

CERTIFICATE HOLDER CANCELLATION
ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved.

CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
$
$
$
$
$
The ACORD name and logo are registered marks of ACORD
10/13/2026
(202) 966-0700 (202) 966-1440
20508
Summit Strategies Affairs LLC
440 1st St NW #440
Washington, DC 20001
20443
35289
A 1,000,000
7013522999 2/1/2026 2/1/2027 1,000,000
10,000
1,000,000
2,000,000
2,000,000
A 1,000,000
7013522999 2/1/2026 2/1/2027
B 3,000,000
X 7013528768 2/1/2026 2/1/2027 3,000,000
10,000
C
7013528737 2/1/2026 2/1/2027 1,000,000 N 1,000,000
1,000,000
A professional liabil 7013522999 2/1/2026 policy limit 1,000,000 A Professional Liabili 7013522999 2/1/2026 2/1/2027 Aggregate Limit 2,000,000 City of Bakersfield, its mayro, council, officers, agents, employees and volunteers are additonal insured under the general liabilty and a waiver of subrogation is provided per attached endorsement SB146932G. the general liability is primary and non-contributoy per wording of attached endorsement CNA801012XX.

Waiver of subrogation applies to the worker's compensation per attached endorsement WC000313. Any endorsement attached and/or described herein apply with respects to the operatios of the named insured as required by written contract executed prior to the loss; subject to statue and policy provisions.

City of Bakersfield Office of Risk Management
1600 Truxtun Ave
Bakersfield, CA 93301
SUMMSTR-01 SHOFFMAN
Howard & Hoffman Insurance Agency
3201 New Mexico Avenue NW, Suite #300
Washington, DC 20016 [email protected]

VALLEY FORGE INS CO

CONTINENTAL CAS CO

CONTINENTAL INS CO
X
2/1/2027
X
X
X
X X
X
X
X
!"!#$%&'()*+,-.///00020009970135229998127
CNA80103XX
(09-14)
CNA80103XX (09-14)

Copyright, CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

PRIMARY AND NONCONTRIBUTORYOTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the following:

BUSINESSOWNERS COMMON POLICY CONDITIONS
The following is added to Paragraph !"#$%&'"()*+',)-& and supersedes any provision to the contrary:
.'/0,'1"2)3"45)-5)$'/6+$5'1"()*+',)-&
This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that:
7! The additional insured is a Named Insured under such other insurance; and 8! You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured.

All other terms and conditions of the Policy remain unchanged. !
"#$%&
!"!#$%&'()*+,-.///00020009970135229998167
SB146932G
(Ed. 10-19)
SB146932G (10-19) Page 1 of 7
Copyright, CNA All Rights Reserved.

BLANKET ADDITIONAL INSURED AND LIABILITY EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following:

BUSINESSOWNERS LIABILITY COVERAGE FORM

BUSINESSOWNERS COMMON POLICY CONDITIONS
!"#$%&'%(&) $) *
+, "-./012%!334245/.-%+/67813%985:4645/6
!, !334245/.-%+/67813%;%"-./012%<1/3586
", =46>1--./1576%!334245/.-%+/678136
(, !334245/.-%985:4645/6%91824/1/2%25%!334245/.-%+/67813%(5:18.?1 @,., 984A.8B%;%)5/>5/284C7258B%D85:4645/
@,C, E1F4/4245/%5F%GH84221/%>5/28.>2G
I, !334245/.-%+/67813%;%$J21/313%(5:18.?1
++, #4.C4-42B%$J21/645/%(5:18.?16
!, "534-B%+/K78B%;%$JD./313%E1F4/4245/
", "85.3%L/5H-13?1%5F%&>>7881/>1
(, $62.216M%#1?.-%N1D8161/2.24:16%./3%*D57616
E, '1--5H%$AD-5B11%'4862%!43
$, #1?.-%#4.C4-42B%;%E.A.?1%25%981A4616
', 91865/.-%./3%!3:182464/?%+/K78B%;%E46>84A4/.245/%58%O7A4-4.245/ P, 91865/.-%./3%!3:182464/?%+/K78B%;%"85.31/13%$:4>245/ O, Q.4:18%5F%*7C85?.245/%;%"-./012
+, "#!)L$ %!EE+ +&)!#%+)*RN$E%9N&<+*+&)*
!, !EE+ +&)!#%+)*RN$E%;%"#!)L$ %<$)E&N*
QS5 +6 !/ +/67813 is amended to include as an additional insured any person or organization (referred to below as vendor) with whom you agreed under a "H84221/ >5/28.>2" to provide insurance, but only with respect to "C534-B 4/K78B" or "D85D182B 3.A.?1" arising out of "B578 D8537>26" which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions:
@, The insurance afforded the vendor does not apply to:
., ""534-B%4/K78B" or "D85D182B%3.A.?1" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; C, Any express warranty unauthorized by you;
>, Any physical or chemical change in the product made intentionally by the vendor; 3, Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container;
1, Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products;
F, Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; ?, Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or !
"#$%&
SB146932G
(Ed. 10-19)
SB146932G (10-19) Page 2 of 7
Copyright, CNA All Rights Reserved.
! ""#$%&' %()*+'" or ",+#,-+.' $/0/1-" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to:
234 The exceptions contained in Subparagraphs $! or 5!; or 264 Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products.
6! This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. 7! This provision 6! does not apply to any vendor included as an insured by an endorsement issued by us and made a part of this Policy.
8! This provision 6! does not apply if "9#$%&' %()*+'" or ",+#,-+.' $/0/1-" included within the ",+#$*:.;< :#0,&-.-$=#,-+/.%#(;= />/+$" is excluded either by the provisions of the Policy or by endorsement. "! ?@ABCDDEFCGHA=EII@J@GFED=@FAHKCIA
3! L # @; E( @(;*+-$ is amended to include as an insured any person or organization (called additional insured) described in paragraphs 7!/! through 7!)! below whom you are required to add as an additional insured on this policy under a "M+%..-(=:#(.+/:.."
6! However, subject always to the terms and conditions of this policy, including the limits of insurance, we will not provide the additional insured with:
/! A higher limit of insurance than required by such "M+%..-(=:#(.+/:.;" 9! Coverage broader than required by such "M+%..-( :#(.+/:." and in no event greater than that described by the applicable paragraph a. through k. below; or
:! Coverage for "9#$%&' %()*+'" or ",+#,-+.' $/0/1-" included within the ",+#$*:.;<:#0,&-.-$ #,-+/.%#(; />/+$." But this paragraph :! does not apply to the extent coverage for such liability is provided by paragraph 7!)! below.

Any coverage granted by this endorsement shall apply only to the extent permitted by law. 7! Only the following persons or organizations can qualify as additional insureds under this endorsement:
/! B#(.+#&&%(1=@(.-+-;.

Any persons or organizations with a controlling interest in you but only with respect to their liability arising out of:
234 such person or organization's financial control of you; or 264 Premises such person or organization owns, maintains or controls while you lease or occupy these premises;
provided that the coverage granted to such additional insureds does not apply to structural alterations, new construction or demolition operations performed by or for such additional insured. 9! B#<#M(-+=#5=@(;*+-$=N+-0%;-;
A co-owner of a premises co-owned by you and covered under this insurance but only with respect to the co-owners liability for "9#$%&' %()*+'," ",+#,-+.' $/0/1-" or ",-+;#(/& /($ /$O-+.%;%(1 %()*+'" as coowner of such premises. :! P+/(.#+=#5=Q+/(: %;-
Any person or organization that has granted a franchise to you, but only with respect to such person or organization's liability for "9#$%&' %()*+'," ",+#,-+.' $/0/1-," or ",-+;#(/& /($ /$O-+.%;%(1 %()*+'" as grantor of a franchise to you.
!"!#$%&'()*+,-.///00020009970135229998168
SB146932G
(Ed. 10-19)
SB146932G (10-19) Page 3 of 7
Copyright, CNA All Rights Reserved.
! "#$$%&'%(')*+,-.#/0
Any person or organization from whom you lease equipment, but only with respect to liability for "1% ,23 ,/4+&3," "-&%-#&03 5.56#" or "-#&$%/52 5/ 5 7#&0,$,/6 ,/4+&3" caused in whole or in part by your maintenance, operation or use of such equipment, provided that the "%88+&&#/8#" giving rise to such "1% ,23 ,/4+&3" or "-&%-#&03 5.56#" or the offense giving rise to such "-#&$%/52 5/ 5 7#&0,$,/6 ,/4+&3" takes place prior to the termination of such lease. #! "#$$%&'%('"5/
Any person or organization from whom you lease land, but only with respect to liability for "1% ,23 ,/4+&3," "-&%-#&03 5.56#" or "-#&$%/52 5/ 5 7#&0,$,/6 ,/4+&3" arising out of the ownership, maintenance or use of that specific part of the land leased to you, provided that the "%88+&&#/8#" giving rise to such "bodily injury" or "-&%-#&03 5.56#" or the offense giving rise to such "-#&$%/52 5/ 5 7#&0,$,/6 ,/4+&3," takes place prior to the termination of such lease. The insurance hereby afforded to the additional insured does not apply to structural alterations, new construction or demolition operations performed by, on behalf of or for such additional insured.
(! "#$$%&'%('9&#.,$#$
An owner or lessor of premises leased to you, or such owner or lessor's real estate manager, but only with respect to liability for "1% ,23 ,/4+&3," "-&%-#&03 5.56#" or "-#&$%/52 5/ 5 7#&0,$,/6 ,/4+&3" arising out of the ownership, maintenance or use of such part of the premises leased to you, and provided that the "%88+&&#/8#" giving rise to such "1% ,23 ,/4+&3" or "-&%-#&03 5.56#" or the offense giving rise to such "-#&$%/52 5/ 5 7#&0,$,/6 ,/4+&3," takes place prior to the termination of such lease.

The insurance hereby afforded to the additional insured does not apply to structural alterations, new construction or demolition operations performed by, on behalf of or for such additional insured. 6! :%&0656##;'<$$,6/##'%&'=#8#,7#&
A mortgagee, assignee or receiver of premises but only with respect to such mortgagee, assignee, or receiver's liability for "1% ,23 ,/4+&3," "-&%-#&03 5.56#" or "-#&$%/52 5/ 5 7#&0,$,/6 ,/4+&3" arising out of the ownership, maintenance, or use of a premises by you.

This insurance does not apply to structural alterations, new construction or demolition operations performed by, on behalf of or for such additional insured. >! ?050#'%&'9%2,0,852'?+1 ,7,$,%/$
A state or government agency or subdivision or political subdivision that has issued a permit or authorization, but only with respect to such government agency or subdivision or political subdivision's liability for "1% ,23',/4+&3," "-&%-#&03' 5.56#" or "-#&$%/52'5/ '5 7#&0,$,/6',/4+&3" arising out of:
@AB The following hazards in connection with premises you own, rent, or control and to which this insurance applies:
@5B The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoistaway openings, sidewalk vaults, street banners, or decorations and similar exposures; or @1B The construction, erection, or removal of elevators; or @8B The ownership, maintenance or use of any elevators covered by this insurance; or @CB The permitted or authorized operations performed by you or on your behalf. But the coverage granted by this paragraph does not apply to:
@5B "D% ,23 ,/4+&3", "-&%-#&03 5.56#" or "-#&$%/52 5/ 5 7#&0,$,/6 ,/4+&3" arising out of operations performed for the state or government agency or subdivision or political subdivision; or
@1B "D% ,23 ,/4+&3" or "-&%-#&03 5.56#" included within the "-&% +80$E8%.-2#0# %-#&50,%/$ >5F5& ."
With respect to this provision's requirement that additional insured status must be requested under a "G&,00#/'8%/0&580," we will treat as a "G&,00#/'8%/0&580" any governmental permit that requires you to add the governmental entity as an additional insured.

SB146932G
(Ed. 10-19)
SB146932G (10-19) Page 4 of 7
Copyright, CNA All Rights Reserved.
! "#$%&'()*+',-&./'0&11*#
With respect to your participation in a trade show event as an exhibitor, presenter or displayer, any person or organization whom you are required to include as an additional insured, but only with respect to such person or organization's liability for "2*% 34 .56#4," "7#*7&#/4 %$8$9&," or "7&#1*.$3 $.% $%-&#/ 1 .9' .56#4" caused by:
$! Your acts or omissions; or
2! Acts or omissions of those acting on your behalf;
in the performance of your ongoing operations at the trade show premises during the trade show event. 5! :/)&#';&#1*.'*#':#9$. <$/ *.

Any person or organization who is not an additional insured under paragraphs $! through ! above. Such additional insured is an insured solely for "2*% 34 .56#4," "7#*7&#/4 %$8$9&" or "7&#1*.$3 $.% $%-&#/ 1 .9' .56#4" for which such additional insured is liable because of your acts or omissions.

The coverage granted by this paragraph does not apply to any person or organization:
=>? For "2*% 34 .56#4," "7#*7&#/4 %$8$9&," or "7&#1*.$3 $.% $%-&#/ 1 .9 .56#4" arising out of the rendering or failure to render any professional services; =@? For "2*% 34 .56#4" or "7#*7&#/4 %$8$9&" included in the "7#*%6A/1BA*873&/&% *7&#$/ *.1 )$<$#%." But this provision =@?'does not apply to such "2*% 34' .56#4" or "7#*7&#/4'%$8$9&" if:
=$? It is entirely due to your negligence and specifically results from your work for the additional insured which is the subject to the "+# //&.'A*./#$A/"; and =2? The "+# //&.'A*./#$A/" requires you to make the person or organization an additional insured for such "2*% 34' .56#4" or "7#*7&#/4'%$8$9&"; or
=C? Who is afforded additional insured coverage under another endorsement attached to this policy.

D! EFFG"G:HE0';I:JG(G:H(';,I"GH,H"'":'EFFG"G:HE0'GH(KI,F'D:J,IEL, >! With respect only to additional insured coverage provided under paragraphs E! and M! above:
$! The MK(GH,((:NH,I( D:OO:H ;:0GDP D:HFG"G:H( are amended to add the following to the Condition entitled :/)&#'G.16#$.A&:

This insurance is excess of all other insurance available to an additional insured whether primary, excess, contingent or on any other basis. However, if a "+# //&. A*./#$A/" requires that this insurance be either primary or primary and noncontributing, then this insurance will be primary and non-contributory relative solely to insurance on which the additional insured is a named insured. 2! Under 0 $2 3 /4'$.%'O&% A$3',Q7&.1&'F&R . / *.1, the following definition is added:
"N# //&. A*./#$A/" means a written contract or agreement that requires you to make a person or organization an additional insured on this policy, provided the contract or agreement:
=>? Is currently in effect or becomes effective during the term of this policy; and =@? Was executed prior to:
=$? The "2*% 34' .56#4" or "7#*7&#/4'%$8$9&;" or
=2? The offense that caused the "7&#1*.$3'$.%'$%-&#/ 1 .9' .56#4"; for which the additional insured seeks coverage.
@! With respect to any additional insured added by this endorsement or by any other endorsement attached to this Coverage Part, the section entitled N)*'G1'E.'G.16#&% is amended to make the following natural persons insureds.

If the additional insured is:
$! An individual, then his or her spouse is an insured; !"!#$%&'()*+,$-...00020009970135229998169
SB146932G
(Ed. 10-19)
SB146932G (10-19) Page 5 of 7
Copyright, CNA All Rights Reserved.
! A partnership or joint venture, then its partners, members and their spouses are insureds; "! A limited liability company, then its members and managers are insureds; #! An organization other than a partnership, joint venture or limited liability company, then its executive officers, directors and shareholders are insureds; or
$! Any type of entity, then its employees are insureds; but only with respect to locations and operations covered by the additional insured endorsement's provisions, and only with respect to their respective roles within their organizations. Furthermore, employees of additional insureds are not insureds with respect to liability arising out of:
%&' "()#*+, *-./0," or "1$02)-3+ 3-# 3#4$05*2*-6 *-./0," to any fellow employee or to any natural person listed in paragraphs 3! through #! above;
%7' "80)1$05,9#3:36$" to property owned, occupied or used by their employer or by any fellow employee; or %;' Providing or failing to provide professional health care services. <<! =<>(<=<?@9AB?ACD<EC9FEGAH>IAD
It is understood and agreed that this endorsement amends the (/2*-$22)J-$02 =*3 *+*5, F)4$036$ K)0:. If any other endorsement attached to this policy amends any provision also amended by this endorsement, then that other endorsement controls with respect to such provision, and the changes made by this endorsement to such provision do not apply.
>! ()#*+,9*-./0, L9AM13-#$#9N$O*-*5*)-
Under =*3 *+*5, 3-# P$#*"3+ AM1$-2$2 N$O*-*5*)-2, the definition of "()#*+, *-./0," is deleted and replaced by the following:
"()#*+, *-./0," means physical injury, sickness or disease sustained by a person, including death, humiliation, shock, mental anguish or mental injury by that person at any time which results as a consequence of the physical injury, sickness or disease.
(! (0)3#9Q-)J+$#6$9)O9E""/00$-"$
Under Businessowners Liability Conditions, the Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended to add the following:

Paragraphs 3! and ! above apply to you or to any additional insured only when such ")""/00$-"$," offense, claim or "2/*5" is known to:
%&' You or any additional insured that is an individual; %7' Any partner, if you or an additional insured is a partnership; %;' Any manager, if you or an additional insured is a limited liability company; %R' Any "$M$"/5*4$9)OO*"$0" or insurance manager, if you or an additional insured is a corporation; %S' Any trustee, if you or an additional insured is a trust; or %T' Any elected or appointed official, if you or an additional insured is a political subdivision or public entity.

This paragraph applies separately to you and any additional insured.

F! A2535$2U9=$63+9H$10$2$-535*4$293-#9D1)/2$2
The estates, heirs, legal representatives and spouses of any natural person insured shall also be insured under this policy; provided, however, coverage is afforded to such estates, heirs, legal representatives and spouses only for claims arising solely out of their capacity as such and, in the case of a spouse, where such claim seeks damages from marital common property, jointly held property, or property transferred from such natural person insured to such spouse. No coverage is provided for any act, error or omission of an estate, heir, legal representative or spouse outside the scope of such person's capacity as such, provided however that the spouse of a natural person Named Insured and the spouses of members or partners of joint venture or partnership Named Insureds are insureds with respect to such spouses' acts, errors or omissions in the conduct of the Named Insured's business.

SB146932G
(Ed. 10-19)
SB146932G (10-19) Page 6 of 7
Copyright, CNA All Rights Reserved.
! "#$$%&'()*$%+##'",-./'0,1'2%3#-45#
In the section entitled 67%'8.'09'89.:-#1, paragraph ;!4!<! is amended to add the following:

The limitations described in subparagraphs ;!4!<!=4>, =?> and =@> do not apply to your "#)*$%+##." for "?%1,$+ ,9A:-+" that results from providing cardiopulmonary resuscitation or other first aid services to a co-"#)*$%+##" or "3%$:9/##- &%-B#-" that becomes necessary while your "#)*$%+##" is performing duties in the conduct of your business. Your "#)*$%+##." are hereby insureds for such services. But the insured status conferred by this provision does not apply to "#)*$%+##." whose duties in your business are to provide professional health care services or health examinations.
(! C#54$'C,4?,$,/+'D' 4)45#'E%'F-#),.#.
<! Under G!'(H@$:.,%9.I <! 0**$,@4?$# /% G:.,9#.. C,4?,$,/+ 2%3#-45#, Exclusion B! 4)45# E% F-%*#-/+, is replaced by the following:

B! 4)45#'E%'F-%*#-/+
"F-%*#-/+'14)45#" to:
<! Property you own, rent or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property;
;! Premises you sell, give away or abandon, if the "*-%*#-/+ 14)45#" arises out of any part of those premises;
J! Property loaned to you;
K! Personal property in the care, custody or control of the insured; L! That particular part of any real property on which you or any contractors or subcontractors working directly or indirectly in your behalf are performing operations, if the "*-%*#-/+ 14)45#" arises out of those operations; or
M! That particular part of any property that must be restored, repaired or replaced because "+%:- &%-B" was incorrectly performed on it.

Paragraph ; of this exclusion does not apply if the premises are "+%:- &%-B" and were never occupied, rented or held for rental by you.

Paragraphs <, J, and K, of this exclusion do not apply to "*-%*#-/+ 14)45#" (other than damage by fire or explosion) to premises:
=<> rented to you:
=;> temporarily occupied by you with the permission of the owner, or =J> to the contents of premises rented to you for a period of 7 or fewer consecutive days.

A separate limit of insurance applies to Damage To Premises Rented To You as described in Section D – Liability and Medical Expenses Limits of Insurance.

Paragraphs J, K, L, and M of this exclusion do not apply to liability assumed under a sidetrack agreement.

Paragraph M of this exclusion does not apply to "*-%*#-/+ 14)45#" included in the "*-%1:@/.N @%)*$#/#1'%*#-4/,%9.'74O4-1."
;! Under G!'(H@$:.,%9., <! 0**$,@4?$# /% G:.,9#.. C,4?,$,/+ 2%3#-45#, the following paragraph is added, and replaces the similar paragraph, if any, beneath paragraph =<K> of the exclusion entitled F#-.%94$ 491 013#-/,.,95'89A:-+:

Exclusions @I 1I #I PI 5I 7I ,I BI $I )I 9I 491 %I do not apply to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner or to the contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in Q#@/,%9' !'C,4?,$,/+'091'R#1,@4$'(H*#9.#.'C,),/.'SP'89.:-49@#. !"!#$%&'()*+,-.///00020009970135229998170
SB146932G
(Ed. 10-19)
SB146932G (10-19) Page 7 of 7
Copyright, CNA All Rights Reserved.
! The first Paragraph under item "! #$%$&' () *+'%,-'- .'/0'1 () 2)3 4,%,0 of the section entitled 4,$5,6,0789/18:'1,;$68<=>'/-'-84,%,0-8?@8A/-3+$/;' is replaced by the following:

The most we will pay under Business Liability for damages because of ">+)>'+07 1$%$&'" to any one premises, while rented to you or temporarily occupied by you with the permission of the owner, including contents of such premises rented to you for a period of 7 or fewer consecutive days, is the Damage to Premises Rented to You Limit. The Damage to Premises Rented to You Limit is the greater of:
$! $1,000,000; or
5! The Damage to Premises Rented to You Limit shown in the Declarations.

B! *'+-)/$68$/1891C'+0,-,/&8A/D3+7 E8#,-;+,%,/$0,)/8)+8F3%,6,$0,)/ G! Under 4,$5,6,07 $/1 :'1,;$6 <=>'/-'- #'@,/,0,)/-, the definition of ">'+-)/$6 $/1 $1C'+0,-,/& ,/D3+7" is amended to add the following:

H! Discrimination or humiliation that results in injury to the feelings or reputation of a natural person, but only if such discrimination or humiliation is:

IGJ Not done intentionally by or at the direction of:

I$J The insured; or
I5J Any "'=';30,C' )@@,;'+," director, stockholder, partner, member or manager (if you are a limited liability company) of the insured; and
IKJ Not directly or indirectly related to the employment, prospective employment, past employment or termination of employment of any person or person by any insured.

K! Under L! <=;63-,)/-M G! 9>>6,;$56' 0) L3-,/'-- 4,$5,6,07 N)C'+$&', the exclusion entitled *'+-)/$6 $/1 91C'+0,-,/&8A/D3+7 is amended to add the following additional exclusions:

IG"J #,-;+,%,/$0,)/8.'6$0,/&80)8.))%M8#O'66,/&8)+8*+'%,-'- Caused by discrimination directly or indirectly related to the sale, rental, lease or sub-lease or prospective sale, rental, lease or sub-lease of any room, dwelling or premises by or at the direction of any insured.

IGPJ <%>6)7%'/08.'6$0'18#,-;+,%,/$0,)/
Discrimination or humiliation directly or indirectly related to the employment, prospective employment, past employment or termination of employment of any person by any insured.

IGQJ B,/'-8)+8*'/$60,'-
Fines or penalties levied or imposed by a governmental entity because of discrimination. ! This provision I*'+-)/$6 $/1 91C'+0,-,/& A/D3+7 E #,-;+,%,/$0,)/ )+ F3%,6,$0,)/J does not apply if *'+-)/$6 $/1 91C'+0,-,/& A/D3+7 Liability is excluded either by the provisions of the Policy or by endorsement.

R! *'+-)/$68$/1891C'+0,-,/&8A/D3+7 S8L+)$1'/'18<C,;0,)/ Under 4,$5,6,07 $/1 :'1,;$6 <=>'/-'- #'@,/,0,)/-, the definition of "*'+-)/$6 $/1 $1C'+0,-,/& ,/D3+7" is amended to delete Paragraph c. and replace it with the following:
;! The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room dwelling or premises that a person or organization occupies committed by or on behalf of its owner, landlord or lessor.

F! T$,C'+8)@8U35+)&$0,)/8E8L6$/V'0
We waive any right of recovery we may have against:
$! Any person or organization with whom you have a written contract that requires such a waiver.

All other terms and conditions of the Policy remain unchanged.

Workers Compensation And Employers Liability Insurance
Insured Name
Summit Strategies Government Affairs LLC
440 1ST ST NW STE 440
WASHINGTON, DC 20001
Policy Number
WC 7 13528737
Policy Period
02/01/2026 to 02/01/2027
Renewal
Producer Information

HOWARD & HOFFMAN INSURANCE AGENCY
3201 NEW MEXICO AVE NW STE 300
WASHINGTON, DC 20016-2710
Producer Processing Code
600-067553
CNA Branch

WASHINGTON DC
2020 K Street, NW
Suite 750
Washington D.C, DC 20006
Thank you for choosing CNA!
With your Workers Compensation And Employers Liability Insurance policy, you have insurance coverage tailored to meet the needs of your business. The international network of insurance professionals and the financial strength of CNA, rated "A" by A.M. Best, provide the resources to help you manage the daily risks of your organization so that you may focus on what’s most important to you.

Claim Services
The Workers Compensation Claim Kit will help you and your employees take full advantage of CNA’s comprehensive services. We work with you, your employees and medical providers to promote workplace safety; control risks; facilitate early return to work when medically appropriate; prevent fraud; and assist you in recognizing your opportunities and responsibilities in managing Workers Compensation costs.

To report a loss go to www.cna.com/claim or send an email to [email protected], or call 877-CNA-ASAP (877-262-2727)
To find a network provider or for a PPO panel request, go to www.cna.com/claim To request loss runs send an email to [email protected] For additional questions call CNA Customer Service at (877)-574-0540, or contact your independent CNA Insurance Agent.

State Required Posting Notices
If you are not the person directly responsible for having these Posting Notices displayed, please direct these notices to the appropriate person within your organization. Posting Notices are required to be displayed in accordance with specific requirements as stated in the notices. The applicable notice(s) and the quantity included are based on the number of physical addresses in each covered state provided by your independent CNA Insurance Agent.
© Copyright CNA All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Table of Contents

TABLE OF CONTENTS
Page Number
TABLE OF CONTENTS ................................................................................. 2 POLICYHOLDER NOTICE ................................................................................. 3 INFORMATION PAGE ................................................................................. 16 POLICY ................................................................................. 26 POLICY ENDORSEMENT ................................................................................. 32 Policy No:

© Copyright CNA All Rights Reserved.

Table of Contents WC 7 13528737
Workers Compensation And Employers Liability Insurance
Policyholder Notice

POLICYHOLDER NOTICE - FRAUD NOTIFICATION

IMPORTANT INFORMATION

POLICYHOLDER FRAUD NOTIFICATION
Alabama, Alaska, Arizona, Connecticut, Delaware, District of Columbia, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, South Carolina, South Dakota, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming:

Any person who knowingly presents false or fraudulent information to obtain or amend insurance coverage or to make a claim for the payment of a loss is guilty of a crime and may be subject to criminal and/or civil penalties.

Arkansas: Any person or entity who willfully and knowingly makes any material false statement or representation, who willfully and knowingly omits or conceals any material information, or who willfully and knowingly employs any device, scheme or artifice, for the purpose of:
i. Obtaining any benefit or payment;
ii. Defeating or wrongfully increasing or wrongfully decreasing any claim for benefit or payment; or
iii. Obtaining or avoiding workers compensation coverage or avoiding payment of the proper insurance premium, or who aids and abets for any of said purposes, under this chapter will be guilty of a Class D felony.

Fifty percent (50%) of any criminal fine imposed and collected under this subdivision (a)(1) or subdivision (a)(2) of this section shall be paid and allocated in accordance with applicable law to the Death and Permanent Total Disability Trust Fund administered by the Workers' Compensation Commission.

California: For your protection, California law requires the following to appear on this form:

Any person who makes or causes to be made any knowingly false or fraudulent material statement or material representation for the purpose of obtaining or denying workers' compensation benefits or payments is guilty of a felony.

Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Policyholder Notice; Page: 1 of 3
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 CNA105749XX (05-2023)
02/01/2026
Policy Page: 3 of 49
© Copyright CNA All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policyholder Notice
Colorado: It is illegal to knowingly make a false or fraudulent material statement or representation for the purpose of obtaining or denying workers' compensation benefits or payments. These actions may result in a loss of future benefits, restitution of prior workers compensation awards and benefits paid, and/or civil and criminal penalties.

Florida: Any person who, knowingly and with intent to injure, defraud, or deceive any employer or employee, insurance company, or self-insured program, files a statement of claim containing any false or misleading information, commits insurance fraud, punishable as provided in s. 817.234.

Louisiana: Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. Failure to answer truthfully may result in forfeiture of workers compensation benefits.

Minnesota: Any person who, with intent to defraud, receives workers’ compensation benefits to which the person is not entitled by knowingly misrepresenting, misstating, or failing to disclose any material fact is guilty of theft and shall be sentenced pursuant to s 609.52, subdivision 3.

New York: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime, and shall also be subject to a civil penalty not to exceed five thousand dollars and the stated value of the claim for each such violation.

Oklahoma: Any person or entity who makes any material false statement or representation, who willfully and knowingly omits or conceals any material information, or who employs any device, scheme, or artifice, or who aids and abets any person for the purpose of:
obtaining any benefit or payment,
increasing any claim for benefit or payment, or
obtaining workers' compensation coverage under this act, shall be guilty of a felony punishable pursuant to Section 1663 of Title 21 of the Oklahoma Statutes.

Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Policyholder Notice; Page: 2 of 3
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 CNA105749XX (05-2023)
02/01/2026
Policy Page: 4 of 49
© Copyright CNA All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policyholder Notice
Rhode Island: Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison.

Tennessee: It is a crime to knowingly provide false, incomplete or misleading information to any party to a workers compensation transaction for the purpose of committing fraud.

Penalties include imprisonment, fines and denial of insurance benefits.

Texas: Any person who knowingly presents a false or fraudulent claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison.

Utah: Any person who knowingly presents false or fraudulent underwriting information, files or causes to be filed a false or fraudulent claim for disability compensation or medical benefits, or submits a false or fraudulent report or billing for health care fees or other professional services is guilty of a crime and may be subject to fines and confinement in state prison.

Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Policyholder Notice; Page: 3 of 3
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 CNA105749XX (05-2023)
02/01/2026
Policy Page: 5 of 49
© Copyright CNA All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policyholder Notice

IMPORTANT INFORMATION - CNA INSURANCE PREMIUM AUDIT
An accurate audit benefits you and your business
What is it and why do you need it?
A premium audit determines the actual insurance exposures for the coverages you have based on an examination of your operation, records and books of account.

At issuance, your premium is estimated based on your business circumstances and information provided at that time. An audit verifies the correct exposure of premium base for your insurance coverage by checking actual figures. After your audit, an adjustment will be made to the premium that was estimated when your policy was issued.

An audit is necessary after the expiration of a policy with a variable premium base. Some types of coverage subject to audit are:

Payroll Records Checklist
This list provides a good indication of materials your auditor will need.

You can also expect your auditor to observe your business operations and ask questions about your records.

Keeping good records may save you time and money
If you are eligible for allowable credits based on insurance manual classification and rating rules, you need to provide the necessary records and detail to take advantage of the credits.

Payroll (remuneration for services performed by an employee) is the basis for many of your insurance premiums. Remuneration can include money or substitutes such as:

Workers' Compensation
Premises Operations Liability
Automobile Liability
Liquor Liability
Product Recall and Replacement
General Liability
Products Completed Operations
Garage Liability
Funeral Directors Liability
Printer’s E&O Correction of Work
Journals
Tax Reports
Vehicle Titles
Cash Disbursements
Ledgers
Individual Earnings Cards
Registrations or Ownership Tax Reports
Bonuses
Wages or commissions
Profit sharing plans
Overtime
Statutory payments
Other substitutes for cash
Vacation, holiday or sick pay
Payments for piece work
Value of board, lodging
Tool allowance
Store certificates
Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Policyholder Notice; Page: 1 of 2
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 CC031605A (12-2014)
02/01/2026
Policy Page: 6 of 49
© Copyright CNA All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policyholder Notice
Scheduling the Audit
As the time for your audit approaches, a staff auditor from CNA or one of our authorized vendors will contact you to schedule the audit. Our current vendors are: Information Providers Inc. (IPI); and U.S. Insurance Services (USI).

Payroll Records Guidelines
Overtime – show overtime pay in excess of straight time pay separately by employee and in summary by classification of work by state.*
Division of Payroll – Individual employee's payroll must show the number of hours and amount of payroll for each type of work or the full salary must be charged to the employee's highest rated classification. Division is not available for outside sales persons (8742), auto salesperson (8748), clerical (8810), clerical telecommuter (8871) and drivers (7380).

Subcontractors – CNA requires all subcontractors hired by you to carry Workers Compensation insurance, and to carry General Liability and/or Umbrella Liability limits of at least $1,000,000 on an occurrence based policy.

Prior to allowing a subcontractor to work for you, you should obtain a Certificate of Insurance from the subcontractor evidencing Workers Compensation insurance and these GL and/or Umbrella minimum limits. At final audit, we will examine the Certificates of Insurance for all work subcontracted during the policy term. Any subcontracted work for which we are not provided a Certificate of Issuance demonstrating Workers Compensation insurance or which demonstrates subcontracted work was insured with liability limits less than $1,000,000., will be converted to ratable payroll on your applicable policies, resulting in additional premium charges owed by you. To prevent such additional premium charges and to reduce the risk of your Workers Compensation and/or General Liability coverages being tapped to cover claims that arise from work performed by your subcontractors, you must obtain certificates of Insurance evidencing Workers Compensation insurance and $1,000,000 liability limits from all of your subcontractors.

Prevailing Wage – In PA, DE, NJ and CA, contact your CNA premium auditor for details concerning cash payments in lieu of prevailing fringe benefits and the records required.

You can reach the Premium Audit Department by calling:

EAST CT, DE, DC, MA, MD, ME, NH, NJ, NY, PA, RI, VA, VT, WV CNA Premium Audit Department
1 Meridian Blvd
Wyomissing, PA 19610
Phone: 800-847-2736
Fax: 610-208-6571
ALL OTHER CNA Premium Audit Department
500 Colonial Center Parkway
Lake Mary, FL 32746
Phone: 800-847-2736
Fax: 407-919-3610
*PA, DE, NV and UT do not allow overtime credit for Workers' Comp coverage. Overtime credit is allowed in all states for General Liability coverages.

One or more of the CNA companies provide the products and/or services described. This information is intended to present a general overview for illustrative purposes only. It is not intended to constitute a binding contract. Please remember that only the relevant insurance policy can provide the actual terms, coverages, amounts, conditions and exclusions for an insured. All products and services may not be available in all states and may be subject to change without notice. CNA is a registered trademark of CNA Financial Corporation. Copyright 2014 CNA. All rights reserved. PREM AUDIT FLR 052014
Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Policyholder Notice; Page: 2 of 2
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 CC031605A (12-2014)
02/01/2026
Policy Page: 7 of 49
© Copyright CNA All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policyholder Notice
IMPORTANT INFORMATION OREGON EMPLOYERS: INTRO TO WORKERS COMPENSATION In accordance with the intent of Oregon Law, this notice answers basic questions about workers compensation insurance.

National Council on Compensation Insurance (NCCI)
The National Council on Compensation Insurance is a voluntary, non-profit, statistical, research and ratemaking organization licensed under Oregon Revised Statutes 737.350. Supported by the insurance industry, NCCI's primary functions are the preparation and administration of rates, rating plans, and systems for workers compensation insurance. In Oregon, NCCI prepares a schedule of rates for insureds in the assigned risk plan, subject to insurance department approval, and acts in an advisory capacity for insurers writing the remainder of the business in the state.

As the rating organization, it is NCCI's obligation to collect payroll and loss information, by individual classification, for each workers compensation insurance policy in the state of Oregon. In addition, the rating organization will perform inspections at employers' premises to determine the proper classifications, perform test audits, promulgate experience rating modifications, and administer the Workers Compensation Insurance Plan (WCIP) for those employers unable to obtain coverage voluntarily.

Workers Compensation Rates
NCCI uses the collected payroll and loss data to actuarially determine that portion of each individual classification rate necessary to pay the losses. This amount is called the pure premium. Oregon insurers may use the pure premiums determined by NCCI, or may derive their own pure premium when preparing their rates.

Each carrier applies it own "factor" to provide for additional costs of taxes, licenses, fees, acquisitions and field supervision, and other company expenses. This "factored" rate is the amount charged per $100 of payroll.

Classifications
There are approximately 500 different workers compensation classifications, each of which individually describes a particular occupation. Generally, each employer will be entitled to the ONE basic classification which most accurately describes its operations. In addition, when that one basic classification does not specifically include one of the "Standard Exception" classifications (Clerical, Outside Salespersons, or Drivers), each employer may also be entitled to three additional classifications: Code 7380 - Drivers, Chauffeurs & Helpers; Code 8742 - Salespersons, Collectors or Messengers - Outside; and Code 8810 - Clerical Office Employees. CNA will advise you of the classification applicable to your operations. However, when an employer is engaged in Construction, Erection, Stevedoring, Aircraft Operations (Industrial Aid) or Trucking as a secondary business, additional classifications may be assigned. Again, CNA will advise you on classifications applicable to your operations.

Division of Employees Payroll
When an employee performs different duties which, if performed by a different worker, would qualify for a different classification assignment, you may divide that person's payroll between two or more classifications, PROVIDED separate verifiable payroll records are adequately maintained. When verifiable payroll records are not maintained, that individual's payroll must be assigned to the highest-rated classification for any of the duties performed.

Verifiable Records
Verifiable records are documents completed by an employee or supervisor every time the employee changes duties. These records should display the starting time and ending time for each type of work. Each block of time should note the duties that employee performed during that particular time period. Estimates or Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Policyholder Notice; Page: 1 of 3
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 G-23130-C (07-2004)
02/01/2026
Policy Page: 8 of 49
© CNA All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policyholder Notice
percentages of time spent in the different duties are not acceptable as verifiable records.

Remuneration – Payroll
"Payroll" means the TOTAL remuneration paid or payable by the employer for the services of the employees covered by the policy. Payroll INCLUDES commissions, anticipated bonuses, straight hourly wages for all hours worked, holiday pay, sick pay, piecework pay, tool allowances, value of living quarters provided by the employer, value of meals provided, value of store certificates or merchandise provided, and credits or any other substitute for money received by employees. Payroll does NOT INCLUDE profit-sharing amounts, unanticipated bonuses, vacation pay, tips or other gratuities received by employees from others, payments by the employer to group insurance or group pension plans, value of special rewards for individual invention or discovery, the value of a company-provided vehicle which is used in the employer's business, or dismissal or severance payments except for the pay earned for the time worked. It also excludes payments from a program to reward workers for safe working practices.

Subcontractors
When you subcontract a portion (or all) of your work to others and retain the right to exercise any direction and control (regardless of whether that right is exercised), you will be expected to pay the premiums for that subcontracted payroll UNLESS the subcontractor has its own workers compensation insurance coverage. In order to avoid the payment of premium for your subcontractors, you should obtain a CERTIFICATE OF INSURANCE from each subcontractor. At the time of audit, we will ask for any certificates of insurance and will exclude the subcontractor's payroll when the certificate is available.

Experience Rating
When any employer's initial policy develops an annual premium in excess of $5,000, the employer will qualify for experience rating at the beginning of the THIRD year and annually thereafter. When the employers develop premium in excess of $2,500 (but less than $5,000), they will qualify for an experience rating modification at the beginning of the FOURTH year. These qualifying premium amounts are subject to change.

Essentially, the Experience Rating Program will use your company's payroll, by individual classification, to determine the AVERAGE amount of losses expected to emerge from that payroll. It will then compare those EXPECTED LOSSES to the ACTUAL LOSSES which were paid and/or reserved for any injuries occurring during the period covered by the data used in the annual experience rating process. When your company has BETTER than average experience, the experience modification will result in a CREDIT (reduction in your final premium), but if your experience is WORSE than average, a DEBIT (surcharge) will apply.

Merit Rating
When an employer is too small to qualify for experience rating, a MERIT RATING program will apply. In general, this program will: a) reduce your final premium if there were no payments for "lost-time" injuries during the most recent year for which data has been compiled; b) will not affect your premium when there was only ONE lost-time injury; and c) will surcharge your premium when there are two or more lost-time injuries. Oregon law provides that, with the approval of regulatory authorities, insurance carriers may use their own customized merit rating plan. Maximum credits or surcharges are 10 percent. CNA has such a program available for insureds.

Federal Coverages
While most employees will be subject to only the Oregon Workers Compensation Act, others MAY be subject to the Admiralty Act (for masters or members of a vessel), to the Federal Employers Liability Act (railroads engaged in interstate commerce), or the Longshore and Harbor Workers Compensation Act (for stevedoring operations, building or repairing of vessels, new construction work in connection with marinas, etc.). However, the determination of exposures under any Federal Acts is a legal question which should be discussed with your insurance agent.

Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Policyholder Notice; Page: 2 of 3
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 G-23130-C (07-2004)
02/01/2026
Policy Page: 9 of 49
© CNA All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policyholder Notice
Final Premium
When you receive your policy from us, the premium will be ESTIMATED from the description of work and payroll information supplied by you. We may either make interim audits or audit your account when your policy has expired. At that time, your final premium will be based upon the ACTUAL payrolls.

Oregon Classification and Rating Committee
A committee, composed of members well-versed in workers compensation insurance matters, meets periodically to hear the grievances of employers who feel they have been treated improperly in the assignment of classifications, payroll assignments, or experience ratings. (Since the "rate" is an actuarial product which has been reviewed by the Department of Consumer and Business Services prior to approval for use, the appeal may NOT be based upon the rate for an individual classification.) Should you feel you have been aggrieved, you may direct your specific allegations to NCCI – Northwestern Service Office, 6975 Southwest Sandburg Road, Suite 146, Tigard, OR 97223 or contact your agent for further information.

Conclusion
The above information has been designed to provide you with a broad overview of the Oregon Workers Compensation Insurance System. Should you have further questions, please contact NCCI – Northwestern Service Office at the address indicated above, or you may contact CNA insurance companies at the following address: CNA Insurance Companies, Two Centerpointe, 2nd Floor, Lake Oswego, OR 97035.

Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Policyholder Notice; Page: 3 of 3
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 G-23130-C (07-2004)
02/01/2026
Policy Page: 10 of 49
© CNA All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policyholder Notice

IMPORTANT INFORMATION NOTICE TO EMPLOYERS

REGARDING MEDICAL PAYMENTS OF NON-DISABLING CLAIMS
Pursuant to ORS 656.262(5); you may pay for the costs of medical services for non-disabling claims, not to exceed the defined dollar amount as determined by the Workers Compensation Division, Department of Consumer and Business Services, per claim. This does not relieve you of your claim reporting requirements or us of our responsibility to determine benefits and to process claims in an accurate and timely manner. That amount you pay of a medical loss covered by the Oregon Employer Paid Medical Program option will be excluded for experience rating purposes upon reimbursement of the deductible amount by the employer.

Non-disabling claims will be processed in accordance with all statutes and rules governing claims processing.

However, you may reimburse the medical services’ costs paid by us, if you have chosen to make such payments. If you do not respond in writing within 30 days of receipt of this notice, we will assume you have chosen not to participate. If you wish to participate later in the policy period, you may, by written request.

However, the earliest reimbursement period will be the first completed period following receipt of your request.

If you elect to participate, the reimbursement program remains in effect until you advise us otherwise, in writing, or are no longer insured by us.

The procedure for reimbursement is as follows:

Within 30 days following each three month period after policy inception or a period mutually agreed upon by us, we shall provide you with a list of all accepted non-disabling claims for which payments were made during that period and the respective cost of each claim. You must identify those claims and the dollar amount you wish to pay for that period and reimburse us accordingly, within 30 days of receipt of the quarterly list. If you do not reimburse us within the 30 days, that will mean that you do not wish to reimburse us. You and we may, by written agreement, establish a period in excess of 30 days for you to reimburse us. We shall maintain records of amounts reimbursed by you for medical services on non-disabling claims.

If a claim changes from a non-disabling claim to a disabling claim and the insurer has recovered reimbursement from the employer for medical costs billed prior to the change, the insurer will exclude those amounts from any experience rating, or other individual or group rating plans of the employer.

For employers on retrospective rated plans, medical costs paid by the employer will be included in the retrospective premium calculation, but those amounts paid by the employer will be applied as credits against the resulting retrospective premium. For employers who are experience rated, the effect of choosing to pay medical costs could eventually reduce their overall workers’ compensation costs.

For additional information or to answer any questions, please contact:

CNA Insurance
12909 S.W. 68th Parkway
Suite 200
Portland, OR 97223
(800)881-1350
Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Policyholder Notice; Page: 1 of 1
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 G-43595-H (12-2010)
02/01/2026
Policy Page: 11 of 49
© CNA All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policyholder Notice

IMPORTANT INFORMATION OREGON SAFETY AND HEALTH LOSS CONTROL SERVICES You, as an employer operating in the State of Oregon, may not be aware of a state law that has a significant impact on you and conditions in your workplace. The Oregon Safe Employment Act is a plan approved under the provisions of the Federal Occupational Safety and Health Act (OSHA) and applies to all businesses engaged in commerce and having one or more employees. The Act is administered by the Oregon OSHA of the Department of Business and Consumer Services.

You, as an employer, have a right to make a complaint to the OR-OSHA Division if an insurer fails to respond to a request for Loss Prevention services, or otherwise fails to provide services as offered or required. A copy of the law, its requirements and interpretations may be obtained from:

Oregon-OSHA
Department of Consumer and Business Services
350 Winter Street NE
Salem, OR 97301
Phone Number: 1-800-922-2689
Website Address: www.cbs.state.or.us/osha/
The Act requires you to take positive action to ensure your employees safe and healthful working conditions, and you are responsible for complying with all standards, rules, regulations and opinions of the Act. CNA encourages you to voluntarily comply with all of its requirements. While we cannot assume your responsibility, we can assist you in this endeavor.

When requested, CNA's Loss Risk Control Department will consult with you regarding your occupational safety and health problems, conditions or methods. Our loss risk control services include:

A) Evaluation of loss prevention risk control needs:

B) Assistance in evaluating records that may be pertinent to the firm's illness and injury experience; C) An explanation to you of the Oregon Safe Employment Act and rules that apply to the particular place of employment;
D) Provision of partial or complete on-site health and safety surveys, which identify all reasonably discoverable occupational safety and health hazards and items not in compliance with the federal and the Division's occupational safety and health laws, rules and standards within the scope of the survey scheduled; E) Assistance with industrial hygiene and safety evaluations to detect physical and chemical hazards of the workplace, and implementation of engineering or administrative controls; F) Assistance with evaluating, obtaining, and maintaining personal protective equipment; G) Evaluation of workplace design, layout and operation, and assistance with job site modifications utilizing an ergonomic approach;
H) Assistance in evaluating and improving safety management practices; I) Assistance in identifying health and safety training needs and available resources; and J) Follow-up services for evaluating the effectiveness of the service provided.

Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Policyholder Notice; Page: 1 of 2
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 G-83274-K (12-2017)
02/01/2026
Policy Page: 12 of 49
© Copyright CNA All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policyholder Notice
If you need assistance, please contact us by letter or phone at the address below.

CNA
12909 S.W. 68th Parkway
Suite 200
Portland, OR 97223
(800) 881-1350
Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Policyholder Notice; Page: 2 of 2
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 G-83274-K (12-2017)
02/01/2026
Policy Page: 13 of 49
© Copyright CNA All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policyholder Notice
IMPORTANT INFORMATION:

DISTRICT OF COLUMBIA WORKERS' COMPENSATION POLICYHOLDER SURCHARGE The District of Columbia Office of Workers' Compensation has issued a notice indicating the assessment for the Special Fund for current Fiscal Year (October 1st - September 30th), as authorized under the District of Columbia Workers' Compensation Act, section 36-340. In the event of an assessment, every workers' compensation insurer must collect, from each of its policyholders, an amount equal to the surcharge percentage multiplied by their premium. The surcharge percentage shall be set by a formula each year (generally effective October 1st) by the Office of Workers' Compensation. The policyholder surcharge rate and the dollar amount are identified on your District of Columbia Schedule of Operations.

Please contact your independent CNA agent if you have any questions.

Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Policyholder Notice; Page: 1 of 1
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 G-138906-G (10-2013)
02/01/2026
Policy Page: 14 of 49
© Copyright CNA All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policyholder Notice

PRIVACY POLICY NOTICE
This notice explains how CNA* protects the privacy of personal information collected about you or your employees under a CNA insurance policy.

Why We Collect Information
We collect information about you or your employees that is necessary to adjust claims made under a CNA insurance policy.

The Type of Information We Collect
Information we receive may include claimant name, address, telephone number, Social Security Number, date of birth, medical treatment records, including information about previous claims or accidents, information about the circumstances of the accident or injury, and the names of witnesses and other contact information.

How We Use the Information
The information we collect is used to administer and process claims, account administration, fraud prevention, and as otherwise required or permitted by federal or state law.

We may share information as required or allowed by law, with:
• Medical providers
• Insurance or workers' compensation regulatory authorities • Law enforcement
• To others, as permitted by law
How We Protect Information
Protecting your non-public personal information is important to us. We do not share your non-public personal information with anyone unless you agree or, as we are required or allowed by law. We regularly review our security measures and employee education programs to help protect your information, including physical security of our files.

Whom To Contact Regarding Privacy Matters
Please include your name and policy or claim number in any correspondence to us.

CNA Compliance
151 N. Franklin St.

Chicago, IL 60606
*THIS NOTICE IS PROVIDED ON BEHALF OF THE FOLLOWING CNA COMPANIES:

American Casualty Company of Reading, PA The Continental Insurance Company of New Jersey Continental Casualty Company National Fire Insurance Company of Hartford The Continental Insurance Company Valley Forge Insurance Company Transportation Insurance Company
Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Policyholder Notice; Page: 1 of 1
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 G-140370-E (05-2019)
02/01/2026
Policy Page: 15 of 49
© Copyright CNA All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Information Page

WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY INFORMATION PAGE Policy Information
Coverage Provided By Policy Number
The Continental Insurance Company a Stock Insurance
Company
151 N Franklin St
Chicago, IL 60606
NCCI Carrier Code: 15113
Policy Number: WC 7 13528737
Renewal of: WC 7 13528737
Item 1 Named Insured and Mailing Address Producer Information Summit Strategies Government Affairs LLC
440 1ST ST NW STE 440
WASHINGTON, DC 20001
Type of Entity: Limited Liability Company
FEIN Number: 81-0898773

HOWARD & HOFFMAN INSURANCE AGENCY
3201 NEW MEXICO AVE NW STE 300
WASHINGTON, DC 20016-2710
Producer Processing Code: 600-067553
If there are other Named Insureds: See Name and Address Schedule attached.

If there are other work places not shown above: See Name and Address Schedule attached.

Item 2 Policy Period
02/01/2026 to 02/01/2027 at 12:01 a.m. Standard Time at the Named Insured's mailing address shown above.

Anniversary Rating Date: NONE
Item 3 A. Workers Compensation Insurance: Part One of this policy applies to the Workers Compensation Law of the states listed here:

States: DC, OR
Item 3 B. Employers Liability Insurance: Part Two of this 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
WC000001
Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Information Page; Page: 1 of 2
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 P-33398-E (06-1987)
02/01/2026
Policy Page: 16 of 49
© Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Information Page
Item 3 C. Other States Insurance: Part Three of this policy applies to the states, if any, listed here:

States: All states except ND, OH, WA, WY and states designated in Item 3A of the Information Page Item 3 D. This policy includes these endorsements and schedules:

Schedule of Operations, Endorsement Schedule, Named Insured Schedule, Name and Address Schedule and Payment Plan Schedule
Item 4 Estimated Annual Premium
The premium for this policy will be determined by our Manual of Rules, Classifications, Rates and Rating Plans.

All information required below is subject to verification and change by audit.

Adjustment of Premium shall be made: At Policy Expiration Classification of Operations: See Schedule of Operations Attached Estimated Annual Premium $938
Premium Discount $0
Expense Constant $160
Terrorism Premium $193
Catastrophe (O/T Cert Acts of Terror) $90
Minimum Premium $179
Total Estimated Annual Premium $1,381
Total State Taxes/Assessments/Surcharges $27.00
Total Estimated Cost $1,408.00
Deposit Premium $1,381
Account Number: 3041560311
Date of Issuance: 12/18/2025
Policy Issuance Office: WASHINGTON DC
Countersigned:

Date:

By:

Authorized Agent
Chairman of the Board Secretary
WC000001
Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Information Page; Page: 2 of 2
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 P-33398-E (06-1987)
02/01/2026
Policy Page: 17 of 49
© Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Information Page
Schedule of Operations
Class
Code
Classification of Operations Estimated
Total Annual
Remun
Rate per
$100
Remun
Estimated
Annual
Premium
State - District of Columbia
Location 001
8810 Clerical Office Employees NOC 146,232 0.0290 $42
8742 Salespersons Or Collectors--Outside 472,443 0.0640 $302 Subtotal for Location # 001 $344
0930 Waiver Of Subrogation 0.0200 $245
9812 Employers Liability Increased Limits 0.0110 $4
9848 Employers Liability Increased Limits - Balance To
Minimum Premium
$115
Total Estimated Standard Premium $708
0900 Expense Constant $160
9740 Terrorism Premium 618,675 0.0290 $179
9741 Catastrophe (O/T Cert Acts Of Terror) 618,675 0.0100 $62 Total Estimated Premium $1,109
0988 WC Policyholder Surcharge 0% $0
Total Estimated Cost $1,109
WC000001
Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Information Page; Page: 1 of 3
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 P-33398-E (06-1987)
02/01/2026
Policy Page: 18 of 49
© Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Information Page
Schedule of Operations
Class
Code
Classification of Operations Estimated
Total Annual
Remun
Rate per
$100
Remun
Estimated
Annual
Premium
State - Oregon
Location 002
8742 Salespersons Or Collectors--Outside 281,216 0.0890 $250 Subtotal for Location # 002 $250
0930 Waiver Of Subrogation 0.0200 $5
9812 Employers Liability Increased Limits 0.0040 $1
9885 OR Merit Rating Credit 0.9000 ($26)
Total Estimated Standard Premium $230
9740 Terrorism Premium 281,216 0.0050 $14
9741 Catastrophe (O/T Cert Acts Of Terror) 281,216 0.0100 $28 Total Estimated Premium $272
0988 Oregon Tax Assessment 9.8% $27
Total Estimated Cost $299
WC000001
Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Information Page; Page: 2 of 3
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 P-33398-E (06-1987)
02/01/2026
Policy Page: 19 of 49
© Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Information Page
Schedule of Operations
Policy Totals Estimated Annual Premium
Estimated Class Premium $594
Estimated Standard Premium $938
Expense Constant $160
Expense Constant State District of Columbia
Terrorism Premium $193
Catastrophe Premium $90
Estimated Annual Premium $1,381
Taxes, Fees and Surcharges $27
Estimated Cost $1,408
WC000001
Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Information Page; Page: 3 of 3
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 P-33398-E (06-1987)
02/01/2026
Policy Page: 20 of 49
© Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Information Page
Endorsement Schedule
Number Edition Date Endorsement Title Endorsement
Number
WC 00 00 00 C 01-2015 WORKERS COMPENSATION AND EMPLOYERS LIABILITY

INSURANCE POLICY
G-35224-B 03-1984 INCREASED LIMIT OF LIABILITY ENDORSEMENT 1 WC 00 03 10 04-1984 SOLE PROPRIETORS, PARTNERS, OFFICERS AND

OTHERS COVERAGE ENDORSEMENT
2 WC 00 03 13 04-1984 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS

ENDORSEMENT
3 WC 00 04 14 A 01-2019 90-DAY REPORTING REQUIREMENT - NOTIFICATION OF

CHANGE IN OWNERSHIP ENDORSEMENT
4 WC 00 04 19 A 08-2022 PART FIVE - PREMIUM AMENDATORY ENDORSEMENT 5 WC 00 04 21 E 01-2021 CATASTROPHE (OTHER THAN CERTIFIED ACTS OF

TERRORISM) PREMIUM ENDORSEMENT
6 WC 00 04 21 F 08-2022 CATASTROPHE (OTHER THAN CERTIFIED ACTS OF

TERRORISM) PREMIUM ENDORSEMENT
7 WC 00 04 22 C 01-2021 TERRORISM RISK INSURANCE PROGRAM

REAUTHORIZATION ACT DISCLOSURE ENDORSEMENT
8 WC 00 04 24 01-2017 AUDIT NONCOMPLIANCE CHARGE ENDORSEMENT 9 WC 08 06 01 04-1984 DISTRICT OF COLUMBIA CANCELATION ENDORSEMENT 10 WC 36 03 06 01-2002 OREGON LIMITS OF LIABILITY ENDORSEMENT 11 WC 36 04 01 01-1988 OREGON MERIT RATING ENDORSEMENT 12
WC 36 06 01 E 01-2008 OREGON CANCELLATION ENDORSEMENT 13 WC 36 06 02 01-2011 OREGON CONFIDENTIALITY ENDORSEMENT 14 WC 36 06 04 01-2017 OREGON AMENDATORY ENDORSEMENT 15

PLEASE READ THE ENCLOSED IMPORTANT NOTICES CONCERNING YOUR POLICY Number Edition Date Form Title
CC031605A 12-2014 CNA INSURANCE PREMIUM AUDIT
CNA105749XX 05-2023 POLICYHOLDER FRAUD NOTIFICATION
G-138906-G 10-2013 IMPORTANT INFORMATION: DISTRICT OF COLUMBIA WORKERS'

COMPENSATION POLICYHOLDER SURCHARGE
G-140370-E 05-2019 PRIVACY POLICY NOTICE
WC000001
Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Information Page; Page: 1 of 2
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 P-33398-E (06-1987)
02/01/2026
Policy Page: 21 of 49
© Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Information Page
Number Edition Date Form Title
G-23130-C 07-2004 IMPORTANT INFORMATION OREGON EMPLOYERS: INTRO TO

WORKERS COMPENSATION
G-43595-H 12-2010 IMPORTANT INFORMATION NOTICE TO EMPLOYERS REGARDING

MEDICAL PAYMENTS OF NON-DISABLING CLAIMS
G-83274-K 12-2017 IMPORTANT INFORMATION OREGON SAFETY AND HEALTH LOSS

CONTROL SERVICES
WC000001
Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Information Page; Page: 2 of 2
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 P-33398-E (06-1987)
02/01/2026
Policy Page: 22 of 49
© Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Information Page
Named Insured Schedule
Named Insured Type of Entity FEIN State ID
Summit Strategies Government Affairs LLC Limited Liability Company
81-0898773
WC000001
Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Information Page; Page: 1 of 1
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 P-33398-E (06-1987)
02/01/2026
Policy Page: 23 of 49
© Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Information Page
Name and Address Schedule
Location Entity Entity Name and Address
1 001 Summit Strategies Government Affairs LLC
440 1ST ST NW
440
WASHINGTON, DC 20001
2 001 Summit Strategies Government Affairs LLC
329 NE COUCH ST # 212
PORTLAND, OR 97232-1332
WC000001
Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Information Page; Page: 1 of 1
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 P-33398-E (06-1987)
02/01/2026
Policy Page: 24 of 49
© Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Information Page

PAYMENT PLAN SCHEDULE

PAYMENT PLAN SCHEDULE
THE BILLING FOR THIS POLICY WILL BE FORWARDED TO YOU DIRECTLY FROM CNA.

THIS PREMIUM WILL BE INVOICED BY CNA ON A SEPARATE STATEMENT ACCORDING TO THE PAYMENT OPTION YOU SELECT.

The premium amount for this transaction is: $1,408.00
WC000001
Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Information Page; Page: 1 of 1
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 P-33398-E (06-1987)
02/01/2026
Policy Page: 25 of 49
© Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policy
In return for the payment of the premium and subject to all terms of this policy, we agree with you as follows:

GENERAL SECTION
A. The Policy
This policy includes at its effective date the
Information Page and all endorsements and
schedules listed there. It is a contract of insurance
between you (the employer named in Item 1 of the
Information Page) and us (the insurer named on the
Information Page). The only agreements relating to
this insurance are stated in this policy. The terms of
this policy may not be changed or waived except by
endorsement issued by us to be part of this policy.

B. Who is Insured
You are insured if you are an employer named in
Item 1 of the Information Page. If that employer is a
partnership, and if you are one of its partners, you
are insured, but only in your capacity as an
employer of the partnership’s employees.

C. Workers Compensation Law
Workers Compensation Law means the workers or
workmen’s compensation law and occupational
disease law of each state or territory named in Item

3.A. of the Information Page. It includes any
amendments to that law which are in effect during
the policy period. It does not include any federal
workers or workmen’s compensation law, any
federal occupational disease law or the provisions
of any law that provide nonoccupational disability
benefits.

D. State
State means any state of the United States of
America, and the District of Columbia.

E. Locations
This policy covers all of your workplaces listed in
Items 1 or 4 of the Information Page; and it covers
all other workplaces in Item 3.A. states unless you
have other insurance or are self-insured for such
workplaces.

PART ONE

WORKERS COMPENSATION INSURANCE
A. How This Insurance Applies
This workers compensation insurance applies to
bodily injury by accident or bodily injury by disease.

Bodily injury includes resulting death.

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

2. 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.

B. We Will Pay
We will pay promptly when due the benefits
required of you by the workers compensation
law.

C. We Will Defend
We have the right and duty to defend at our
expense any claim, proceeding or suit against
you for benefits payable by this insurance. We
have the right to investigate and settle these
claims, proceedings or suits.

We have no duty to defend a claim, proceeding
or suit that is not covered by this insurance.

D. We Will Also Pay
We will also pay these costs, in addition to
other amounts payable under this insurance, as
part of any claim, proceeding or suit we
defend:

1. reasonable expenses incurred at our
request, but not loss of earnings;

2. premiums for bonds to release attachments
and for appeal bonds in bond amounts up
to the amount payable under this
insurance;

3. litigation costs taxed against you;

4. interest on a judgment as required by law
until we offer the amount due under this
insurance; and

5. expenses we incur.

E. Other Insurance
We will not pay more than our share of
benefits and costs covered by this insurance
and other insurance or self-insurance. Subject
to any limits of liability that may apply, all
shares will be equal until the loss is paid. If any
insurance or self-insurance is exhausted, the
Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Policy; Page: 1 of 6
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 WC 00 00 00 C (01-2015)
02/01/2026
Policy Page: 26 of 49
© Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policy
shares of all remaining insurance will be equal until
the loss is paid.

F. Payments You Must Make
You are responsible for any payments in excess of
the benefits regularly provided by the workers
compensation law including those required because:

1. of your serious and willful misconduct;

2. you knowingly employ an employee in violation
of law;

3. you fail to comply with a health or safety law or
regulation; or

4. you discharge, coerce or otherwise discriminate
against any employee in violation of the workers
compensation law.

If we make any payments in excess of the benefits
regularly provided by the workers compensation law
on your behalf, you will reimburse us promptly.

G. Recovery From Others
We have your rights, and the rights of persons
entitled to the benefits of this insurance, to recover
our payments from anyone liable for the injury. You
will do everything necessary to protect those rights
for us and to help us enforce them.

H. Statutory Provisions
These statements apply where they are required by
law.

1. As between an injured worker and us, we have
notice of the injury when you have notice.

2. Your default or the bankruptcy or insolvency of
you or your estate will not relieve us of our
duties under this insurance after an injury
occurs.

3. We are directly and primarily liable to any
person entitled to the benefits payable by this
insurance. Those persons may enforce our
duties; so may an agency authorized by law.

Enforcement may be against us or against you
and us.

4. Jurisdiction over you is jurisdiction over us for
purposes of the workers compensation law. We
are bound by decisions against you under that
law, subject to the provisions of this policy that
are not in conflict with that law.

5. This insurance conforms to the parts of the
workers compensation law that apply to:
a. benefits payable by this insurance;
b. special taxes, payments into security or
other special funds, and assessments
payable by us under that law.

6. Terms of this insurance that conflict with
the workers compensation law are changed
by this statement to conform to that law.

Nothing in these paragraphs relieves you of
your duties under this policy.

PART TWO

EMPLOYERS LIABILITY INSURANCE
A. How This Insurance Applies
This employers liability 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 your work in a state or
territory listed in Item 3.A. of the
Information Page.

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

4. 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.

5. 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.

B. We Will Pay
We will pay all sums that you legally must pay
as damages because of bodily injury to your
employees, provided the bodily injury is
covered by this Employers Liability Insurance.

The damages we will pay, where recovery is
permitted by law, include damages:

Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Policy; Page: 2 of 6
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 WC 00 00 00 C (01-2015)
02/01/2026
Policy Page: 27 of 49
© Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policy

1. For which you are liable to a third party by
reason of a claim or suit against you by that
third party to recover the damages claimed
against such third party as a result of injury to
your employee;

2. For care and loss of services; and

3. For consequential bodily injury to a spouse,
child, parent, brother or sister of the injured
employee; provided that these damages are the
direct consequence of bodily injury that arises
out of and in the course of the injured
employee’s employment by you; and

4. Because of bodily injury to your employee that
arises out of and in the course of employment,
claimed against you in a capacity other than as
employer.

C. Exclusions
This insurance does not cover:

1. Liability assumed under a contract. This
exclusion does not apply to a warranty that
your work will be done in a workmanlike
manner;

2. Punitive or exemplary damages because of
bodily injury to an employee employed in
violation of law;

3. Bodily injury to an employee while employed in
violation of law with your actual knowledge or
the actual knowledge of any of your executive
officers;

4. Any obligation imposed by a workers
compensation, occupational disease,
unemployment compensation, or disability
benefits law, or any similar law;

5. Bodily injury intentionally caused or aggravated
by you;

6. Bodily injury occurring outside the United States
of America, its territories or possessions, and
Canada. This exclusion does not apply to bodily
injury to a citizen or resident of the United
States of America or Canada who is temporarily
outside these countries;

7. Damages arising out of coercion, criticism,
demotion, evaluation, reassignment, discipline,
defamation, harassment, humiliation,
discrimination against or termination of any
employee, or any personnel practices, policies,
acts or omissions;

8. Bodily injury to any person in work subject
to the Longshore and Harbor Workers’
Compensation Act (33 U.S.C. Sections
901 et seq.), the Nonappropriated Fund
Instrumentalities Act (5 U.S.C. Sections
8171 et seq.), the Outer Continental Shelf
Lands Act (43 U.S.C. Sections 1331 et
seq.), the Defense Base Act (42 U.S.C.

Sections 1651–1654), the Federal Mine
Safety and Health Act (30 U.S.C. Sections
801 et seq. and 901–944), any other
federal workers or workmen’s
compensation law or other federal
occupational disease law, or any
amendments to these laws;

9. Bodily injury to any person in work subject
to the Federal Employers’ Liability Act (45
U.S.C. Sections 51 et seq.), any other
federal laws obligating an employer to pay
damages to an employee due to bodily
injury arising out of or in the course of
employment, or any amendments to those
laws;

10. Bodily injury to a master or member of the
crew of any vessel, and does not cover
punitive damages related to your duty or
obligation to provide transportation,
wages, maintenance, and cure under any
applicable maritime law;

11. Fines or penalties imposed for violation of
federal or state law; and

12. Damages payable under the Migrant and
Seasonal Agricultural Worker Protection
Act (29 USC Sections 1801–1872) and
under any other federal law awarding
damages for violation of those laws or
regulations issued there under, and any
amendments to those laws.

D. We Will Defend
We have the right and duty to defend, at our
expense, any claim, proceeding or suit against
you for damages payable by this insurance. We
have the right to investigate and settle these
claims, proceedings and suits.

We have no duty to defend a claim, proceeding
or suit that is not covered by this insurance.

We have no duty to defend or continue
Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Policy; Page: 3 of 6
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 WC 00 00 00 C (01-2015)
02/01/2026
Policy Page: 28 of 49
© Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policy
defending after we have paid our applicable limit of
liability under this insurance.

E. We Will Also Pay
We will also pay these costs, in addition to other
amounts payable under this insurance, as part of
any claim, proceeding, or suit we defend:

1. Reasonable expenses incurred at our request,
but not loss of earnings;

2. Premiums for bonds to release attachments and
for appeal bonds in bond amounts up to the
limit of our liability under this insurance;

3. Litigation costs taxed against you;

4. Interest on a judgment as required by law until
we offer the amount due under this insurance;
and

5. Expenses we incur.

F. Other Insurance
We will not pay more than our share of damages
and costs covered by this insurance and other
insurance or self-insurance. Subject to any limits of
liability that apply, all shares will be equal until the loss is paid. If any insurance or self-insurance is
exhausted, the shares of all remaining insurance
and self-insurance will be equal until the loss is
paid.

G. Limits of Liability
Our liability to pay for damages is limited. Our limits of liability are shown in Item 3.B. of the Information
Page. 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—policy limit” is the
most we will pay for all damages covered by
this insurance and arising out of bodily injury by
disease, regardless of the number of employees
who sustain bodily injury by disease. The limit
shown for “bodily injury by disease—each
employee” is the most we will pay for all
damages because of bodily injury by
disease to any one employee.

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.

H. Recovery From Others
We have your rights to recover our payment
from anyone liable for an injury covered by this
insurance. You will do everything necessary to
protect those rights for us and to help us
enforce them.

I. Actions Against Us
There will be no right of action against us
under this insurance unless:

1. You have complied with all the terms of
this policy; and

2. The amount you owe has been determined
with our consent or by actual trial and final
judgment.

This insurance does not give anyone the right
to add us as a defendant in an action against
you to determine your liability. The bankruptcy
or insolvency of you or your estate will not
relieve us of our obligations under this Part.

PART THREE

OTHER STATES INSURANCE
A. How This Insurance Applies

1. This other states insurance applies only if
one or more states are shown in Item 3.C.
of the Information Page.

2. If you begin work in any one of those
states after the effective date of this policy
and are not insured or are not self-insured
for such work, all provisions of the policy
will apply as though that state were listed
in Item 3.A. of the Information Page.

3. We will reimburse you for the benefits
required by the workers compensation law
of that state if we are not permitted to pay
the benefits directly to persons entitled to
them.

Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Policy; Page: 4 of 6
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 WC 00 00 00 C (01-2015)
02/01/2026
Policy Page: 29 of 49
© Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policy

4. If you have work on the effective date of this
policy in any state not listed in Item 3.A. of the
Information Page, coverage will not be afforded
for that state unless we are notified within
thirty days.

B. Notice
Tell us at once if you begin work in any state listed
in Item 3.C. of the Information Page.

PART FOUR

YOUR DUTIES IF INJURY OCCURS
Tell us at once if injury occurs that may be covered
by this policy. Your other duties are listed here.

1. Provide for immediate medical and other
services required by the workers compensation
law.

2. Give us or our agent the names and addresses
of the injured persons and of witnesses, and
other information we may need.

3. Promptly give us all notices, demands and legal
papers related to the injury, claim, proceeding
or suit.

4. Cooperate with us and assist us, as we may
request, in the investigation, settlement or
defense of any claim, proceeding or suit.

5. Do nothing after an injury occurs that would
interfere with our right to recover from others.

6. Do not voluntarily make payments, assume
obligations or incur expenses, except at your
own cost.

PART FIVE—PREMIUM
A. Our Manuals
All premium for this policy will be determined by
our manuals of rules, rates, rating plans and
classifications. We may change our manuals and
apply the changes to this policy if authorized by law
or a governmental agency regulating this insurance.

B. Classifications
Item 4 of the Information Page shows the rate and
premium basis for certain business or work
classifications. These classifications were assigned
based on an estimate of the exposures you would
have during the policy period. If your actual
exposures are not properly described by those
classifications, we will assign proper
classifications, rates and premium basis by
endorsement to this policy.

C. Remuneration
Premium for each work classification is
determined by multiplying a rate times a
premium basis. Remuneration is the most
common premium basis. This premium basis
includes payroll and all other remuneration paid
or payable during the policy period for the
services of:

1. all your officers and employees engaged in
work covered by this policy; and

2. all other persons engaged in work that
could make us liable under Part One
(Workers Compensation Insurance) of this
policy. If you do not have payroll records
for these persons, the contract price for
their services and materials may be used as
the premium basis. This paragraph 2 will
not apply if you give us proof that the
employers of these persons lawfully
secured their workers compensation
obligations.

D. Premium Payments
You will pay all premium when due. You will
pay the premium even if part or all of a
workers compensation law is not valid.

E. Final Premium
The premium shown on the Information Page,
schedules, and endorsements is an estimate.

The final premium will be determined after this
policy ends by using the actual, not the
estimated, premium basis and the proper
classifications and rates that lawfully apply to
the business and work covered by this policy.

If the final premium is more than the premium
you paid to us, you must pay us the balance. If
it is less, we will refund the balance to you.

The final premium will not be less than the
highest minimum premium for the
classifications covered by this policy.

If this policy is canceled, final premium will be
determined in the following way unless our
manuals provide otherwise:

Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Policy; Page: 5 of 6
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 WC 00 00 00 C (01-2015)
02/01/2026
Policy Page: 30 of 49
© Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policy

1. If we cancel, final premium will be calculated
pro rata based on the time this policy was in
force. Final premium will not be less than the
pro rata share of the minimum premium.

2. If you cancel, final premium will be more than
pro rata; it will be based on the time this policy
was in force, and increased by our short-rate
cancelation table and procedure. Final premium
will not be less than the minimum premium.

F. Records
You will keep records of information needed to
compute premium. You will provide us with copies
of those records when we ask for them.

G. Audit
You will let us examine and audit all your records
that relate to this policy. These records include
ledgers, journals, registers, vouchers, contracts, tax
reports, payroll and disbursement records, and
programs for storing and retrieving data. We may
conduct the audits during regular business hours
during the policy period and within three years after
the policy period ends. Information developed by
audit will be used to determine final premium.

Insurance rate service organizations have the same
rights we have under this provision.

PART SIX—CONDITIONS
A. Inspection
We have the right, but are not obliged to inspect
your workplaces at any time. Our inspections are
not safety inspections. They relate only to the
insurability of the workplaces and the premiums to
be charged. We may give you reports on the
conditions we find. We may also recommend
changes. While they may help reduce losses, we do
not undertake to perform the duty of any person to
provide for the health or safety of your employees
or the public. We do not warrant that your
workplaces are safe or healthful or that they comply
with laws, regulations, codes or standards.

Insurance rate service organizations have the same
rights we have under this provision.

B. Long Term Policy
If the policy period is longer than one year and
sixteen days, all provisions of this policy will
apply as though a new policy were issued on
each annual anniversary that this policy is in
force.

C. Transfer of Your Rights and Duties
Your rights or duties under this policy may not
be transferred without our written consent.

If you die and we receive notice within thirty
days after your death, we will cover your legal
representative as insured.

D. Cancelation

1. You may cancel this policy. You must mail
or deliver advance written notice to us
stating when the cancelation is to take
effect.

2. We may cancel this policy. We must mail
or deliver to you not less than ten days
advance written notice stating when the
cancelation is to take effect. Mailing that
notice to you at your mailing address
shown in Item 1 of the Information Page
will be sufficient to prove notice.

3. The policy period will end on the day and
hour stated in the cancelation notice.

4. Any of these provisions that conflict with a
law that controls the cancelation of the
insurance in this policy is changed by this
statement to comply with the law.

E. Sole Representative
The insured first named in Item 1 of the
Information Page will act on behalf of all
insureds to change this policy, receive return
premium, and give or receive notice of
cancelation.

Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Policy; Page: 6 of 6
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 WC 00 00 00 C (01-2015)
02/01/2026
Policy Page: 31 of 49
© Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policy Endorsement

INCREASED LIMIT OF LIABILITY ENDORSEMENT
It is agreed that the premium for the increased Limit of Liability Under Part Two-Employers' Liability Insurance shall be determined by applying an increase percentage of 1.10% to the total premium development in all states appearing in Item 3, except as specifically stated below, at manual or adjusted rates, exclusive of the premium for Loss and Expense Constants and Additional Medical Coverage, subject to a minimum premium of $120.00.

It is further agreed that, in lieu of the increase percentage and minimum premium shown above, the total premium developed at manual or adjusted rates, exclusive of the premium for Loss and Expense Constants and Additional Medical Coverage for the following states shall be subject to the designated increase percentage and minimum premium for determining the premium for increasing the Limit of Liability.

STATE INCREASE PERCENTAGE MINIMUM PREMIUM
OR 0.40% $120.00

TOTAL MINIMUM PREMIUM TO BE CHARGED ON THIS ENDORSEMENT INCLUDED All other terms and conditions of the policy remain unchanged.

This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below.

WC 7 13528737
Endorsement No: 1; Page: 1 of 1 Policy Page: 32 of 49
Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: G-35224-B (03-1984)
Endorsement Effective Date:

Policy No:

Endorsement Expiration Date: Policy Effective Date: 02/01/2026 © CNA All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policy Endorsement

SOLE PROPRIETORS, PARTNERS, OFFICERS AND OTHERS COVERAGE ENDORSEMENT An election was made by or on behalf of each person described in the Schedule to be subject to the workers compensation law of the state named in the Schedule. The premium basis for the policy includes the remuneration of such persons.

Persons State
Schedule
Sole Proprietor:

Partners:

Officers:

Others:

Jim Beall OR
Michelle Giguere OR
Mark Dedrick DC
Hal Hiemstra DC
Jim Kolb DC
All other terms and conditions of the policy remain unchanged.

This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below.

WC 7 13528737
Endorsement No: 2; Page: 1 of 1 Policy Page: 33 of 49
Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: WC 00 03 10 (04-1984)
Endorsement Effective Date:

Policy No:

Endorsement Expiration Date: Policy Effective Date: 02/01/2026 © Copyright CNA All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policy Endorsement

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
Any Person or Organization on whose behalf you are required to obtain this waiver of our right to recover from under a written contract or agreement.

The premium charge for the endorsement is reflected in the Schedule of Operations.

All other terms and conditions of the policy remain unchanged.

This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below.

WC 7 13528737
Endorsement No: 3; Page: 1 of 1 Policy Page: 34 of 49
Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: WC 00 03 13 (04-1984)
Endorsement Effective Date:

Policy No:

Endorsement Expiration Date: Policy Effective Date: 02/01/2026 Copyright 1983 National Council on Compensation Insurance.

Workers Compensation And Employers Liability Insurance
Policy Endorsement
90-DAY REPORTING REQUIREMENT - NOTIFICATION OF CHANGE IN OWNERSHIP ENDORSEMENT You must report any change in ownership to us in writing within 90 days of the date of the change. Change in ownership includes sales, purchases, other transfers, mergers, consolidations, dissolutions, formations of a new entity, and other changes provided for in the applicable experience rating plan. Experience rating is mandatory for all eligible insureds. The experience rating modification factor, if any, applicable to this policy, may change if there is a change in your ownership or in that of one or more of the entities eligible to be combined with you for experience rating purposes.

Failure to report any change in ownership, regardless of whether the change is reported within 90 days of such change, may result in revision of the experience rating modification factor used to determine your premium.

This reporting requirement applies regardless of whether an experience rating modification is currently applicable to this policy.

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 Policy No. Endorsement No.

Insured Premium
Insurance Company Countersigned by _________________________________________ WC 7 13528737
Endorsement No: 4; Page: 1 of 1 Policy Page: 35 of 49
Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: WC 00 04 14 A (01-2019)
Endorsement Effective Date:

Policy No:

Endorsement Expiration Date: Policy Effective Date: 02/01/2026 © Copyright 2018 National Council on Compensation Insurance, Inc. All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policy Endorsement
PART FIVE – PREMIUM AMENDATORY ENDORSEMENT
This endorsement amends Part Five—Premium of the policy as follows:

Part Five—Premium, Section A. (Our Manuals) is replaced by the following provision:

A. Our Manuals
All premium for this policy will be determined by our manuals of rules, rates and loss costs (as applicable), rating plans, forms, endorsements, and classifications, and such manuals are expressly incorporated by reference into, and apply to, this policy and any renewals (our manuals). As used in this policy and any renewals, our manuals means manuals that have been:

1. Developed in any format and filed by the state-designated workers compensation rating or advisory organization on our behalf with the appropriate state insurance regulatory authority; or

2. Developed in any format and filed by the respective state rating bureau on our behalf with the appropriate state insurance regulatory authority; or

3. Developed in any format and filed by us with the appropriate state insurance regulatory authority; and

4. For each or any of the three scenarios above, the manuals also must be approved for use by the appropriate state insurance regulatory authority, or as otherwise authorized by law as applicable.

We may change our manuals and apply the changes to this policy and any renewals if such manual changes are approved for use by the appropriate state insurance regulatory authority, or as otherwise authorized by law as applicable.

Part Five—Premium, Section D. (Premium Payments) is replaced by the following provision:

D. Premium Payments
You will pay all premium when due. You will pay the premium even if part or all of a workers compensation law is not valid. The due date for audit and retrospective premiums is the due date specified in the billing for the policy.

All other terms and conditions of the policy remain unchanged.

This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below.

WC 7 13528737
Endorsement No: 5; Page: 1 of 1 Policy Page: 36 of 49
Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: WC 00 04 19 A (08-2022)
Endorsement Effective Date:

Policy No:

Endorsement Expiration Date: Policy Effective Date: 02/01/2026 © Copyright 2021 National Council on Compensation Insurance, Inc. All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policy Endorsement

CATASTROPHE (OTHER THAN CERTIFIED ACTS OF TERRORISM) PREMIUM ENDORSEMENT a.
b.
c.

This endorsement is notification that your insurance carrier is charging premium to cover the losses that may occur in the event of a Catastrophe (Other Than Certified Acts of Terrorism) as that term is defined below.

Your policy provides coverage for workers compensation losses caused by a Catastrophe (Other Than Certified Acts of Terrorism). This premium charge does not provide funding for Certified Acts of Terrorism contemplated under the Terrorism Risk Insurance Program Reauthorization Act Disclosure Endorsement (WC 00 04 22 C), attached to this policy.

For purposes of this endorsement, the following definitions apply:

Catastrophe (Other Than Certified Acts of Terrorism): Any single event, resulting from an Earthquake, Noncertified Act of Terrorism, or Catastrophic Industrial Accident, which results in aggregate workers compensation losses in excess of $50 million.

Earthquake: The shaking and vibration at the surface of the earth resulting from underground movement along a fault plane or from volcanic activity.

Noncertified Act of Terrorism: An event that is not certified as an Act of Terrorism by the Secretary of the Treasury pursuant to the Terrorism Risk Insurance Act of 2002 (as amended) but that meets all of the following criteria:

It is an act that is violent or dangerous to human life, property, or infrastructure; The act results in damage within the United States, or outside of the United States in the case of the premises of United States missions or air carriers or vessels as those terms are defined in the Terrorism Risk Insurance Act of 2002 (as amended); and
It is an act that has been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion.

Catastrophic Industrial Accident: A chemical release, large explosion, or small blast that is localized in nature and affects workers in a small perimeter the size of a building.

The premium charge for the coverage your policy provides for workers compensation losses caused by a Catastrophe (Other Than Certified Acts of Terrorism) is shown in Item 4 of the Information Page or in the Schedule below.

Schedule
State Rate Premium
Refer to the Schedule of Operations
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 Policy No. Endorsement No.

Insured Premium
Insurance Company Countersigned by _________________________________________ WC 7 13528737
Endorsement No: 6; Page: 1 of 1 Policy Page: 37 of 49
Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: WC 00 04 21 E (01-2021)
Endorsement Effective Date:

Policy No:

Endorsement Expiration Date: Policy Effective Date: 02/01/2026 © Copyright 2020 National Council on Compensation Insurance, Inc. All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policy Endorsement

CATASTROPHE (OTHER THAN CERTIFIED ACTS OF TERRORISM) PREMIUM ENDORSEMENT This endorsement is notification that we are charging premium to cover the losses that may occur in the event of a Catastrophe (Other Than Certified Acts of Terrorism) as that term is defined below. Your policy provides coverage for workers compensation losses caused by a Catastrophe (Other Than Certified Acts of Terrorism).

Coverage for such losses is subject to all terms, definitions, exclusions, and conditions in your policy, and any applicable federal and/or state laws, rules, or regulations. This premium charge does not provide funding for Certified Acts of Terrorism contemplated under the Terrorism Risk Insurance Program Reauthorization Act Disclosure Endorsement attached to this policy.

For purposes of this endorsement, Catastrophe (Other Than Certified Acts of Terrorism) is defined as: A single event or peril resulting in a group of claims with aggregate workers compensation losses in excess of $50 million. This $50 million threshold applies per occurrence, across all states for which claims arise from a single event or peril.

The premium charge for the coverage your policy provides for workers compensation losses caused by a Catastrophe (Other Than Certified Acts of Terrorism) is shown in Item 4 of the Information Page or in the Schedule below.

Schedule
State Rate Premium
Refer to the Schedule of Operations
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 Policy No. Endorsement No.

Insured Premium
Insurance Company Countersigned by _________________________________________ WC 7 13528737
Endorsement No: 7; Page: 1 of 1 Policy Page: 38 of 49
Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: WC 00 04 21 F (Ed. 08-2022 Countrywide, Ed. 07-2022 in Texas) Endorsement Effective Date:

Policy No:

Endorsement Expiration Date: Policy Effective Date: 02/01/2026 © Copyright 2021 National Council on Compensation Insurance, Inc. All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policy Endorsement

TERRORISM RISK INSURANCE PROGRAM REAUTHORIZATION ACT DISCLOSURE ENDORSEMENT a.
b.
c.
d.

This endorsement addresses the requirements of the Terrorism Risk Insurance Act of 2002 as amended and extended by the Terrorism Risk Insurance Program Reauthorization Act of 2019. It serves to notify you of certain limitations under the Act, and that your insurance carrier is charging premium for losses that may occur in the event of an Act of Terrorism.

Your policy provides coverage for workers compensation losses caused by Acts of Terrorism, including workers compensation benefit obligations dictated by state law. Coverage for such losses is still subject to all terms, definitions, exclusions, and conditions in your policy, and any applicable federal and/or state laws, rules, or regulations.

Definitions
The definitions provided in this endorsement are based on and have the same meaning as the definitions in the Act. If words or phrases not defined in this endorsement are defined in the Act, the definitions in the Act will apply.
“Act” means the Terrorism Risk Insurance Act of 2002, which took effect on November 26, 2002, and any amendments thereto, including any amendments resulting from the Terrorism Risk Insurance Program Reauthorization Act of 2019.
“Act of Terrorism” means any act that is certified by the Secretary of the Treasury, in consultation with the Secretary of Homeland Security, and the Attorney General of the United States, as meeting all of the following requirements:

The act is an act of terrorism.

The act is violent or dangerous to human life, property, or infrastructure.

The act resulted in damage within the United States, or outside of the United States in the case of the premises of United States missions or certain air carriers or vessels.

The act has been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion.
“Insured Loss” means any loss resulting from an act of terrorism (and, except for Pennsylvania, including an act of war, in the case of workers compensation) that is covered by primary or excess property and casualty insurance issued by an insurer if the loss occurs in the United States or at the premises of United States missions or to certain air carriers or vessels.
“Insurer Deductible” means, for the period beginning on January 1, 2021, and ending on December 31, 2027, an amount equal to 20% of our direct earned premiums during the immediately preceding calendar year.

Limitation of Liability
The Act limits our liability to you under this policy. If aggregate Insured Losses exceed $100,000,000,000 in a calendar year and if we have met our Insurer Deductible, we are not liable for the payment of any portion of the amount of Insured Losses that exceeds $100,000,000,000; and for aggregate Insured Losses up to $100,000,000,000, we will pay only a pro rata share of such Insured Losses as determined by the Secretary of the Treasury.

WC 7 13528737
Endorsement No: 8; Page: 1 of 2 Policy Page: 39 of 49
Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: WC 00 04 22 C (01-2021)
Endorsement Effective Date:

Policy No:

Endorsement Expiration Date: Policy Effective Date: 02/01/2026 © Copyright 2020 National Council on Compensation Insurance, Inc. All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policy Endorsement

1. 2.

3. Policyholder Disclosure Notice
Insured Losses would be partially reimbursed by the United States Government. If the aggregate industry Insured Losses occurring in any calendar year exceed $200,000,000, the United States Government would pay 80% of our Insured Losses that exceed our Insurer Deductible.

Notwithstanding item 1 above, the United States Government will not make any payment under the Act for any portion of Insured Losses that exceed $100,000,000,000.

The premium charge for the coverage your policy provides for Insured Losses is included in the amount shown in Item 4 of the Information Page or in the Schedule below.

Schedule
State Rate Premium
Refer to the Schedule of Operations
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 Policy No. Endorsement No.

Insured Premium
Insurance Company Countersigned by _________________________________________ WC 7 13528737
Endorsement No: 8; Page: 2 of 2 Policy Page: 40 of 49
Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: WC 00 04 22 C (01-2021)
Endorsement Effective Date:

Policy No:

Endorsement Expiration Date: Policy Effective Date: 02/01/2026 © Copyright 2020 National Council on Compensation Insurance, Inc. All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policy Endorsement

AUDIT NONCOMPLIANCE CHARGE ENDORSEMENT
Part Five-Premium, Section G. (Audit) of the Workers Compensation and Employers Liability Insurance Policy is revised by adding the following:

If you do not allow us to examine and audit all of your records that relate to this policy, and/or do not provide audit information as requested, we may apply an Audit Noncompliance Charge. The method for determining the Audit Noncompliance Charge by state, where applicable, is shown in the Schedule below.

If you allow us to examine and audit all of your records after we have applied an Audit Noncompliance Charge, we will revise your premium in accordance with our manuals and Part 5—Premium, E. (Final Premium) of this policy.

Failure to cooperate with this policy provision may result in the cancellation of your insurance coverage, as specified under the policy.

Note:

For coverage under state-approved workers compensation assigned risk plans, failure to cooperate with this policy provision may affect your eligibility for coverage.

SCHEDULE
State(s) Basis of Audit Noncompliance
Charge
Maximum Audit Noncompliance
Charge Multiplier
DC Estimated Annual Premium 2
OR Estimated Annual Premium 2
All other terms and conditions of the policy remain unchanged.

This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below.

WC 7 13528737
Endorsement No: 9; Page: 1 of 1 Policy Page: 41 of 49
Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: WC 00 04 24 (01-2017)
Endorsement Effective Date:

Policy No:

Endorsement Expiration Date: Policy Effective Date: 02/01/2026 © Copyright 2015 National Council on Compensation Insurance, Inc. All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policy Endorsement

DISTRICT OF COLUMBIA CANCELATION ENDORSEMENT
This endorsement applies only to the insurance provided by the policy because District of Columbia is shown in Item 3.A. of the Information Page.

The Cancelation Condition of the policy is replaced by this Condition:

D. Cancelation

1. You may cancel this policy. You must mail or deliver advance notice to us stating when the cancelation is to take effect.

2. We may cancel this policy. We will mail or deliver to you and the Mayor not less than 30 days advance written notice stating when the cancelation is to take effect. Mailing this notice to you at your mailing address last known to us will be sufficient to prove notice.

3. The policy period will end on the day and hour stated in the cancelation notice.

All other terms and conditions of the policy remain unchanged.

This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below.

WC 7 13528737
Endorsement No: 10; Page: 1 of 1 Policy Page: 42 of 49
Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: WC 08 06 01 (04-1984)
Endorsement Effective Date:

Policy No:

Endorsement Expiration Date: Policy Effective Date: 02/01/2026 © Copyright 1984 National Council on Compensation Insurance.

Workers Compensation And Employers Liability Insurance
Policy Endorsement

OREGON LIMITS OF LIABILITY ENDORSEMENT
This endorsement applies only to the insurance provided by the policy because Oregon is shown in Item 3.A. of the Information Page.

The limits of our liability under Part Two of the policy are:

Bodily Injury by Accident $500,000 or the amount shown in Item 3.B. of the Information Page, whichever is greater, each accident
Bodily Injury by Disease $500,000 or the amount shown in Item 3.B. of the Information Page, whichever is greater, policy limit
Bodily Injury by Disease $500,000 or the amount shown in Item 3.B. of the Information Page, whichever is greater, each employee
This change applies to the insurance this policy provides for Oregon operations only.

All other terms and conditions of the policy remain unchanged.

This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below.

WC 7 13528737
Endorsement No: 11; Page: 1 of 1 Policy Page: 43 of 49
Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: WC 36 03 06 (01-2002)
Endorsement Effective Date:

Policy No:

Endorsement Expiration Date: Policy Effective Date: 02/01/2026 Copyright 2001 National Council on Compensation Insurance, Inc.

Workers Compensation And Employers Liability Insurance
Policy Endorsement

OREGON MERIT RATING ENDORSEMENT
This endorsement applies to the insurance provided by this policy because Oregon is shown in Item 3.A. of the Information Page.

The premium for this insurance is subject to the merit rating shown in the Schedule because your premium is less than the amount necessary to be eligible for experience rating. A merit rating adjustment will not be applied if your final premium is calculated to be the Oregon minimum premium for the insured classifications.

Schedule
Merit Rating Modification
See Item 4 of the Information Page
All other terms and conditions of the policy remain unchanged.

This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below.

WC 7 13528737
Endorsement No: 12; Page: 1 of 1 Policy Page: 44 of 49
Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: WC 36 04 01 (01-1988)
Endorsement Effective Date:

Policy No:

Endorsement Expiration Date: Policy Effective Date: 02/01/2026 © Copyright 1987 National Council on Compensation Insurance.

Workers Compensation And Employers Liability Insurance
Policy Endorsement

OREGON CANCELLATION ENDORSEMENT
This endorsement applies only to the insurance provided by the policy because Oregon is shown in Item 3.A. of the Information Page.

The Cancellation Condition of the policy is replaced by this Condition:

D. Cancellation

1. You may cancel this policy. You must mail or deliver advance written notice to us, stating when the cancellation is to take effect. If you provide for other insurance or self-insurance, your cancellation of coverage will take effect upon the effective date of that insurance.

2. We may cancel this policy. We will mail to you advance written notice stating when the cancellation is to take effect.
a. If we cancel based on our decision not to offer insurance to all employers within your premium category, we will mail the notice of cancellation at least 90 days before the cancellation is to take effect.
b. If we cancel for other reasons, we will mail the notice of cancellation at least 45 days before the cancellation is to take effect.
c. If we cancel for nonpayment, we will mail notice of cancellation at least 10 days before the cancellation is to take effect.

3. Mailing notice to you at your last known mailing address will be sufficient to prove notice.

4. The policy period will end at 12:00 midnight on the day stated in the cancellation notice.

5. When coverage is placed with another carrier as of the policy expiration date, a rejected renewal policy shall be withdrawn without charge, provided notice of nonrenewal is mailed and postmarked on or before the expiration date and is received from the insured by the insurer no later than 10 calendar days after said expiration date.

All other terms and conditions of the policy remain unchanged.

This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below.

WC 7 13528737
Endorsement No: 13; Page: 1 of 1 Policy Page: 45 of 49
Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: WC 36 06 01 E (01-2008)
Endorsement Effective Date:

Policy No:

Endorsement Expiration Date: Policy Effective Date: 02/01/2026 © Copyright 2007 National Council on Compensation Insurance, Inc. All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policy Endorsement

OREGON CONFIDENTIALITY ENDORSEMENT
We may furnish you with certain documentation that includes confidential information. As used in this endorsement, "confidential information" means any and all medical and vocational claim records and information about an injured worker. We make this information available to you for the sole purpose of assisting us to manage, defend, or adjust claims.

1. You agree to hold all information provided by us in trust and confidence.

2. You and your employees must not disclose confidential information about an injured worker to anyone except us unless required to do so by law or with written consent of the injured worker. You will take steps necessary to protect the confidentiality of information about injured workers, including obtaining specific contractual promises from your employees and agents not to disclose any confidential information except as provided in this endorsement. You must not use confidential information for purposes other than those necessary to directly further the purposes of this endorsement.

3. You must not use confidential information in such a manner that is likely to allow other persons to know the name or identity of an injured worker, or allow other persons to know any other particulars of a worker's injury claim, except for those matters over which you as an employer have the ability and the right to direct and control. In no case can you use confidential information either singly or in concert to discriminate unlawfully against any injured worker.

All other terms and conditions of the policy remain unchanged.

This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below.

WC 7 13528737
Endorsement No: 14; Page: 1 of 1 Policy Page: 46 of 49
Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: WC 36 06 02 (01-2011)
Endorsement Effective Date:

Policy No:

Endorsement Expiration Date: Policy Effective Date: 02/01/2026 Copyright 2010 National Council on Compensation Insurance, Inc. All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policy Endorsement

OREGON AMENDATORY ENDORSEMENT

5. 13.

Part Two—Employers Liability Insurance, Section C. (Exclusions), Item 5. of the policy is replaced by the following:

Any bodily injury intentionally caused or aggravated by you, or that is the result of your engaging in conduct equivalent to an intentional tort, however defined, including as described by ORS 656.156, or other tortious conduct, or conduct or activity as described by ORS 656.018(3), such that you lose your immunity from civil liability under the workers compensation laws of Oregon; Part Two—Employers Liability Insurance, Section C. (Exclusions) of the policy is revised by adding the following:

Any cause of action or remedy arising out of or under ORS 656.019 or ORS 654.305 through ORS 654.336.

All other terms and conditions of the policy remain unchanged.

This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below.

WC 7 13528737
Endorsement No: 15; Page: 1 of 1 Policy Page: 47 of 49
Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: WC 36 06 04 (01-2017)
Endorsement Effective Date:

Policy No:

Endorsement Expiration Date: Policy Effective Date: 02/01/2026 © Copyright 1991 National Council on Compensation Insurance.

Workers Compensation And Employers Liability Insurance
Policy Schedule

POSTING NOTICE SCHEDULE

THE FOLLOWING POSTING NOTICES WILL BE ATTACHED TO THE POLICY State CNA Form State Form Form Description Qty
DC G301249-C 1 DCWC NOTICE OF COMPLIANCE 1
DC CNA96984-B 1 DCWC NOTICE OF COMPLIANCE (SPANISH) 1
OR G301191B INSTRUCTION TO REQUEST OR POSTING
NOTICE
1 THE FOLLOWING POSTING NOTICES WILL BE MAILED UNDER SEPARATE COVER State CNA Form State Form Form Description Qty
None
Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Policy Schedule; Page: 1 of 2
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 CNA82027XX (03-2015)
02/01/2026
Policy Page: 48 of 49
© Copyright CNA All Rights Reserved.

Workers Compensation And Employers Liability Insurance
Policy Schedule

THE FOLLOWING POSTING NOTICE DATA IS INTENDED FOR CNA INTERNAL PROCESSING PURPOSES ONLY Tag Field Name Field Value
001 EMPLOYER NAME Summit Strategies Government A
002 EMPLOYER CITY WASHINGTON
003 EMPLOYER STATE DC
004 EMPLOYER ZIP 20001
005 EMPLOYER FEIN 81-0898773
006 INSURANCE CARRIER NAME THE CONTINENTAL INSURANCE CO 007 INSURANCE CARRIER BUREAU CODE 0164
008 INSURANCE CARRIER (OR TPA) NAME THE CONTINENTAL INSURANCE CO 009 POLICY NUMBER WC 7 13528737
010 POLICY EFFECTIVE DATE 02/01/2026
011 POLICY EXPIRATION DATE 02/01/2027
012 AGENT NAME HOWARD & HOFFMAN INSURANCE AGE
013 AGENT STREET ADDRESS 3201 NEW MEXICO AVE NW STE 300 014 AGENT CITY WASHINGTON
015 AGENT STATE DC
016 AGENT ZIP 20016
017 AGENT PHONE 202-966-0700
018 ADJUSTING COMPANY NAME THE CONTINENTAL INSURANCE CO 019 EMPLOYER STREET ADDRESS 440 1ST ST NW STE 440
020 EMPLOYER PHONE 220-595-9039
021 CLAIM PHONE 877-CNA-ASAP (262-2727)
022 CLAIM EMAIL [email protected]
Form No: Policy No:

Policy Effective Date:

Underwriting Company:

WC 7 13528737
Policy Schedule; Page: 2 of 2
The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 CNA82027XX (03-2015)
02/01/2026
Policy Page: 49 of 49
© Copyright CNA All Rights Reserved.