AgdaPkt 2016-09-12 Closed and Joint SA PFA

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ENDORSEMENT NO. 1 CSAC EXCESS INSURANCE AUTHORITY EXCESS WORKERS’ COMPENSATION ALTERNATE EMPLOYER ENDORSEMENT It is understood and agreed that the Memorandum of Coverage is amended as follows: This endorsement applies only with respect to “bodily injury” to the “Covered Party’s” “employees” while in the course of special or temporary employment by Union Pacific Railroad Company pursuant to the Industry Track Contract, Articles of Agreement, Railroad Folder #2545-56. Coverage will apply as though the alternate employer is covered by the Authority. However, the coverage afforded by this endorsement is not intended to satisfy the alternate employer's duty to secure its obligations under the “Workers’ Compensation Act”. The Authority will not ask any other insurer of the alternate employer to share with it a “loss” covered by this endorsement. Subject to the limits shown on the Declarations, under Coverage Agreement I.A., the Authority will reimburse the alternate employer for the benefits required by the “Workers’ Compensation Act” if the Authority is not permitted to pay the benefits directly to the persons entitled to them. The Memorandum may be canceled according to its terms without sending notice to the alternate employer. It is further agreed that nothing herein shall act to increase the Authority's limit of indemnity. This endorsement is part of the Memorandum of Coverage and takes effect on the effective date of the Memorandum of Coverage unless another effective date is shown below. All other terms and conditions remain unchanged. Effective Date: Memorandum No.: EIA-PE 15 EWC-100 Issued to: City of Redwood City Issue Date: June 26, 2015 Authorized Representative CSAC Excess Insurance Authority 6.1.C. - Page 65