Item 10. Policy Forms and Endorsements:

| Form | CE 85 00 08 18 | Excess Liability Short Form - NYFTZ |
| --- | --- | --- |
| CE 85 06 08 18 | Cap on Losses from Certified Acts of Terrorism - NYFTZ |
| NP 73 12 02 20 | Terrorism Insurance Premium Disclosure and Opportunity to Reject |
| NP 93 98 10 13 | Important Notice Your Action Required |
| SNI 04 01 01 20 | Liberty Mutual Group California Privacy Notice |
| CE 85 08 08 18 | Economic or Trade Sanctions Condition - NYFTZ |

In Witness Whereof, we have caused this Policy to be signed by our authorized officers.

Mark Touhey
David H. Long

Secretary
President

CE 85 01 08 18
© 2018 Liberty Mutual Insurance
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Includes copyrighted material of Insurance Services Office, Inc., and Aon plc., with their permission.