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Includes copyrighted material of Insurance <br />GA 210 09 20 Services Office, Inc., with its permission.Page 2 of 14 <br />Each Occurrence Limit:$10,000 <br />Deductible Amount:$250 <br />C.Coverages <br />1.Employee Benefit Liability Coverage <br />a.The following is added to Section I - <br />Coverages: <br />EMPLOYEE BENEFIT LIABILITY <br />COVERAGE <br />(1)Insuring Agreement <br />(a)We will pay those sums that <br />the insured becomes legally <br />obligated to pay as damag- <br />es caused by any act, error <br />or omission of the insured, <br />or of any other person for <br />whose acts the insured is <br />legally liable, to which this <br />insurance applies. W e will <br />have the right and duty to <br />defend the insured against <br />any "suit"seeking those <br />damages. However, we will <br />have no duty to defend <br />against any "suit"seeking <br />damages to which this in- <br />surance does not apply. We <br />may,at our discretion, in- <br />vestigate any report of an <br />act, error or omission and <br />settle any claim or "suit"that <br />may result. But: <br />1)The amount we will pay <br />for damages is limited <br />as described in C. Cov- <br />erages,1.Employee <br />Benefit Liability Cover- <br />age, c.Limits Of Insur- <br />ance of this endorse- <br />ment; and <br />2)Our right and duty to <br />defend ends when we <br />have used up the appli- <br />cable limit of insurance <br />in the payment of judg- <br />ments or settlements. <br />No other obligation or liabil- <br />ity to pay sums or perform <br />acts or services is covered <br />unless explicitly provided for <br />under Supplementary Pay- <br />ments. <br />(b)This insurance applies to <br />damages only if the act, er- <br />ror or omission is negligently <br />committed in the "admin- <br />istration"of your "employee <br />benefit program"; and <br />1)Occurs during the policy <br />period; or <br />2)Occurred prior to the <br />"first effective date"of <br />this endorsement pro- <br />vided: <br />a)You did not have <br />knowledge of a <br />claim or "suit"on or <br />before the "first ef- <br />fective date"of this <br />endorsement. <br />You will be <br />deemed to have <br />knowledge of a <br />claim or "suit" <br />when any insured <br />listed under C. <br />Coverages,1. <br />Employee Benefit <br />Liability Coverage, <br />b. Who Is An In- <br />sured,(1) of this <br />endorsement or <br />any "employee" <br />authorized by you <br />to give or receive <br />notice of a claim or <br />"suit": <br />i)Reports all, or <br />any part,of the <br />act, error or <br />omission to us <br />or any other <br />insurer; <br />ii)Receives a <br />written or ver- <br />bal demand or <br />claim for dam- <br />ages because <br />of the act, er- <br />ror or omis- <br />sion; and <br />b)There is no other <br />applicable insur- <br />ance. <br />(2)Exclusions <br />This insurance does not apply to: <br />(a)Bodily Injury, Property <br />Damage Or Personal And <br />Advertising Injury <br />"Bodily injury", "property <br />damage"or "personal and <br />advertising injury". <br />Docusign Envelope ID: B63767C6-D0E5-432E-8D24-65B6372E87EC