Common use of Long-term Disability Coverage Clause in Contracts

Long-term Disability Coverage. Standard Monthly Benefit $10,000 (guaranteed for life) Rider No. 1 $ 5,000 (guaranteed for life) Rider No. 2 $ 2,669 (guaranteed for 3 years, then must reapply) Total Monthly Benefit $17,669 In the event the participant is disabled for more than 365 days, Lloyds of London will issue a one-time lump sum payment of $1,000,000. Long-term disability policy premiums (for both standard coverage and riders) will be paid by the Company. Signature of Participant: Date: October 27, 2020

Long-term Disability Coverage. Standard Monthly Benefit $10,000 (guaranteed for life) Rider No. 1 $ 5,000 (guaranteed for life) Rider No. 2 $ 2,669 (guaranteed for 3 years, then must reapply) Total Monthly Benefit $17,669 In the event the participant is disabled for more than 365 days, Lloyds of London will issue a one-time lump sum payment of $1,000,000. Long-term disability policy premiums (for both standard coverage and riders) will be paid by the Company. Signature of Participant: /s/ Xxxx Xxxxxx Date: October 27January __, 20202021

Long-term Disability Coverage. Standard Monthly Benefit $10,000 (guaranteed for life) Rider No. 1 $ 5,000 (guaranteed for life) Rider No. 2 $ 2,669 $18,433 (guaranteed for 3 years, then must reapply) Total Monthly Benefit $17,669 33,433 In the event the participant is disabled for more than 365 days, Lloyds of London will issue a one-time lump sum payment of $1,000,000. Long-term disability policy premiums (for both standard coverage and riders) will be paid by the Company. Signature of Participant: /s/ Xxxxxxx X. Xxxxxx Date: October 27February 5, 20202013

Long-term Disability Coverage. Standard Monthly Benefit $10,000 (guaranteed for life) Rider No. 1 $ 5,000 (guaranteed for life) Rider No. 2 $ 2,669 5,098 (guaranteed for 3 years, then must reapply) Total Monthly Benefit $17,669 20,098 In the event the participant is disabled for more than 365 days, Lloyds of London will issue a one-time lump sum payment of $1,000,000. Long-term disability policy premiums (for both standard coverage and riders) will be paid by the Company. Signature of Participant: Date: October 27, 2020/s/ Xxx Xxxxxxxxxx

Long-term Disability Coverage. Standard Monthly Benefit $10,000 (guaranteed for life) Rider No. 1 $ 5,000 (guaranteed for life) Rider No. 2 $ 2,669 $18,433 (guaranteed for 3 years, then must reapply) Total Monthly Benefit $17,669 33,433 In the event the participant is disabled for more than 365 days, Lloyds of London will issue a one-time lump sum payment of $1,000,000. Long-term disability policy premiums (for both standard coverage and riders) will be paid by the Company. Signature of Participant: Date: October 27/s/ Xxxxxxx X. "Xxxx" Xxxxxxx, 2020Jr.

Long-term Disability Coverage. Standard Monthly Benefit $10,000 (guaranteed for life) Rider No. 1 $ 5,000 (guaranteed for life) Rider No. 2 $ 2,669 (guaranteed for 3 years, then must reapply) Total Monthly Benefit $17,669 In the event the participant is disabled for more than 365 days, Lloyds of London will issue a one-time lump sum payment of $1,000,000. Long-term disability policy premiums (for both standard coverage and riders) will be paid by the Company. Signature of Participant: /s/ Xxxxxxxxx X. Xxxxxx Date: October 27January 20, 20202021

Long-term Disability Coverage. Standard Monthly Benefit $10,000 (guaranteed for life) Rider No. 1 $ 5,000 (guaranteed for life) Rider No. 2 $ 2,669 (guaranteed for 3 years, then must reapply) Total Monthly Benefit $17,669 In the event the participant is disabled for more than 365 days, Lloyds of London will issue a one-time lump sum payment of $1,000,000. Long-term disability policy premiums (for both standard coverage and riders) will be paid by the Company. Signature of Participant: /s/ Xxxxxxxxx Xxxxxxxx Date: October 27January 20, 20202021

Long-term Disability Coverage. Standard Monthly Benefit $10,000 (guaranteed for life) Rider No. 1 $ 5,000 (guaranteed for life) Rider No. 2 $ 2,669 $25,000 (guaranteed for 3 years, then must reapply) Total Monthly Benefit $17,669 40,000 In the event the participant is disabled for more than 365 days, Lloyds of London will issue a one-time lump sum payment of $1,000,000. Long-term disability policy premiums (for both standard coverage and riders) will be paid by the Company. Signature of Participant: Date: October 27, 2020/s/ Xxxxx Xxxxxxxxx

Long-term Disability Coverage. Standard Monthly Benefit $10,000 (guaranteed for life) Rider No. 1 $ 5,000 (guaranteed for life) Rider No. 2 $ 2,669 $21,100 (guaranteed for 3 years, then must reapply) Total Monthly Benefit $17,669 36,100 In the event the participant is disabled for more than 365 days, Lloyds of London will issue a one-time lump sum payment of $1,000,000. Long-term disability policy premiums (for both standard coverage and riders) will be paid by the Company. Signature of Participant: Date: October 27, 2020/s/ Xxxxxx X. Xxxxx

Long-term Disability Coverage. Standard Monthly Benefit $10,000 (guaranteed for life) Rider No. 1 $ 5,000 (guaranteed for life) Rider No. 2 $ 2,669 (guaranteed for 3 years, then must reapply) Total Monthly Benefit $17,669 In the event the participant is disabled for more than 365 days, Lloyds of London will issue a one-time lump sum payment of $1,000,000. Long-term disability policy premiums (for both standard coverage and riders) will be paid by the Company. Signature of Participant: Date: October 27, 2020/s/ Xxxxxxx X. Xxx Xxxxxx