| Title | Form # | Ed. | Restriction in Coverage from Prior Year | Comments |
|---|---|---|---|---|
| EARLIER NOTICE OF CANCELLATION AND NON-RENEWAL | ALL10617b | 0614 | Collision Deductible Excluded; UM Excluded; UIM Excluded | 90: 90 |
| EMPLOYEES AS INSUREDS | CA9933 | 1013 |  |  |
| FELLOW EMPLOYEE COVERAGE | CA2055 | 1013 | Total Vehicles 0 |  |
| HIRED AUTOS SPECIFIED AS COVERED AUTOS YOU OWN | CA9916 | 1013 | All autos hired for a period of 180 days or longer |  |
| KNOWLEDGE OF AN ACCIDENT | DA5X68b | 0614 | Vice President of IBM Risk & Insurance |  |
| KY LOCAL GOVERNMENT PREMIUM TAX SCHEDULE | ALI32677a | 0412 | Tax Code: 0166 Tax Amount:$ 62 |  |
| MEXICO COVERAGE ENDORSEMENT | DA9T51 | 0793 |  |  |
| MOTOR CARRIER ENDORSEMENT | MCS90 | 0621 | Primary = 5,000,000 Limit |  |
| NEW YORK DEDUCTIBLE ENDORSEMENT FULL ALAE REIMBURSEMENT, DEDUCTIBLE EQUALS LIMIT | DA49396 | 0617 | Deductible 5,000,000 |  |
| NON-CONTRIBUTORY FOR ADDITIONAL INSUREDS | DA21886b | 0614 | Any additional insured with whom you have agreed to provide such non-contributory insurance, pursuant to and as required under a written contract executed prior to the date of loss. |  |
| NOTICE TO OTHERS ENDORSEMENT - SPECIFIC PARTIES | ALL32688 | 0111 | Name: Los Angeles Department of Water and Power, Risk Management Section; Address: PO Box 51111, Room 465-JFB, Los Angeles, CA 90051-0100 |  |
| NOTIFICATION OF PREMIUM ADJUSTMENT | ALL18057 | 1211 |  |  |
| NUCLEAR ENERGY LIABILITY EXCLUSION | IL0021 | 0908 |  |  |
| PUBLIC ENTITY ADDITIONAL INSURED | ALL22422 | 0507 | Los Angeles Department of Water and Power, Risk Management Section, P.O. Box 51111, Rm 465, Los Angeles, California 90051-0100 |  |
| TRADE OR ECONOMIC SANCTIONS ENDORSEMENT | ALL21101 | 1106 |  |  |
| UNINSURED MOTORISTS AND UNDERINSURED MOTORISTS COVERAGE SUMMARY | DA40002 | 0413 | 1. MI, OH, PR; 2. AL, AK, AZ, AR, CA, CO, DE, FL, GA, HI, ID, IN, IA, KY, LA, MS, MT, NV, NM, OK, PA, TN, TTX, UT, WA, WY; 3. All states not listed in items 1,2 or 4 of this form; 4. The policy limit for liability shall apply for |  |

**INTERNA_05212023_William Overby**
**04/28/2023**
**Limits and Coverages Page 41 of 55**