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Amok <br /> TRAVELERS J One Tower Square, Hartford, Connecticut 06183 <br /> EMPLOYMENT PRACTICES LIABILITY+ POLICY NO.: 680-0R370053-20-42 <br /> WITH IDENTITY FRAUD EXPENSE ISSUE DATE:10/14/2020 <br /> REIMBURSEMENTCOVERAGE PART <br /> DECLARATIONS <br /> THIS FORM PROVIDES CLAIMS-MADE COVERAGE WITH DEFENSE EXPENSES <br /> INCLUDED IN THE LIMIT OF LIABILITY FOR EMPLOYMENT PRACTICES LIABILITY <br /> COVERAGE <br /> INSURING COMPANY:TRAVELERS CASUALTY INSURANCE COMPANY OF AMERICA <br /> POLICY PERIOD: From 06/01/2020 to 06/01/2021 12:01 A.M. Standard Time at your mailing address shown <br /> in the Common Policy Declarations. <br /> The Employment Practices Liability+ With Identity Fraud Expense Reimbursement Coverage Part consists of <br /> these Declarations and the Coverage Form shown below. <br /> ITEM 1. LIMIT OF INSURANCE AND RETENTION FOR EMPLOYMENT PRACTICES LIABILITY <br /> COVERAGE <br /> Limit of Insurance: $ 100,000 <br /> (Defense Expenses are included within the Limit of Insurance) <br /> Retention Amount applicable to each Employment Practices Liability Claim: $ 2,500 <br /> ITEM 2. LIMIT OF INSURANCE AND DEDUCTIBLE FOR IDENTITY FRAUD EXPENSE <br /> REIMBURSEMENT COVERAGE <br /> Limit of Insurance: $ 2,500 <br /> Deductible Amount applicable to Identity Fraud Expense Reimbursement: $ 0 <br /> ITEM 3. EMPLOYMENT PRACTICES LIABILITY COVERAGE EXTENDED REPORTING PERIOD <br /> Subject to the terms and conditions of the Employment Practices Liability Coverage, an optional Extended Re- <br /> porting Period may be purchased for: 12 months for 75% % of the Premium for the Policy Period. <br /> ITEM 4. EMPLOYMENT PRACTICES LIABILITY CONTINUITY DATE <br /> Continuity Date: 09/11/2018 <br /> ITEM 5. PREMIUM: INCLUDED <br /> ITEM 6. NUMBERS OF FORMS, SCHEDULES AND ENDORSEMENTS FORMING THIS COVERAGE <br /> PART ARE ATTACHED AS A SEPARATE LISTING. <br /> PR TO 07 02 15 ©2015 The Travelers Indemnity Company.All rights reserved. Page 1 of 1 <br />