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ENDORSEMENT SCHEDULE <br />State Form Nbr.Ed. Date Description <br />Policy Number: <br />Named Insured: <br />Agent: <br />WORKERS' COMPENSATION AND EMPLOYERS <br />LIABILITY INSURANCE POLICY <br />EIG 5927483 00 <br />PROGRESSIVE SOLUTIONS INC <br />ADP - PITTSBURGH - SBS 0033005 <br />EMPLOYERS PREFERRED INS. CO. <br />P.O. BOX 539003 <br />HENDERSON, NV 89053-9003 <br />A Stock Company <br />CA WC040306 (4/84)CA WAIVER OUR RIGHT TO RECOVER <br />Issued Date: <br />WC990633 (5/98 Ed.) <br />INSURED COPY06/10/2025 <br />Page 6 of 6 <br />Docusign Envelope ID: 2EA41CCF-A2B2-47D6-84CA-2A61682545FC