# FORMS AND ENDORSEMENT SCHEDULE

It is hereby understood and agreed the following forms and endorsements are attached to and are a part of this policy:

| # | Form Number | Form Name |
|---|-------------|-----------|
| 1 | CEX0002 0413 | Excess Liability Policy Declarations |
| 2 | BCIM0066 0513 | General Change Endorsement-Claim Notice |
| 3 | BCIM0066 0513 | General Change Endorsement-Schedule of Underlying Policies |
| 4 | BCIM0066 0513 | General Change Endorsement-Participation Endorsement |
| 5 | BCIM0066 0513 | General Change Endorsement-Asbestos Exclusion |
| 6 | CX 21 01 09 08 | Nuclear Energy Liability Exclusion Endorsement |
| 7 | BCIM0066 0513 | General Change Endorsement- War Exclusion |
| 8 | BCIM0066 0513 | General Change Endorsement-Exclusion-Violation of Information Statutes |
| 9 | BCIM0066 0513 | General Change Endorsement-Crisis Response & Communication Management Insurance Exclusion |
| 10 | BCIM0066 0513 | General Change Endorsement-Following Form Coverage Endorsement |
| 11 | IL 09 85 01 08 | Disclosure Pursuant to Terrorism Risk Insurance Act |
| 12 | CX 21 30 09 08 | Cap on Losses from Certified Acts of Terrorism |
| 13 | CX 01 14 06 10 | New York Changes |
| 14 | CX 01 15 01 11 | New York Changes-Transfer of Duties When a Limit of Insurance is Used Up |
| 15 | CX 02 33 06 10 | New York Changes-Cancellation and Nonrenewal |
| 16 | IL 00 17 11 98 | Common Policy Conditions |
| 17 | CX 00 01 04 13 | Commercial Excess Liability Coverage Form |
| 18 | IL DS 77 00 | Signature Page |
| 19 | IL P 001 01 04 | ("OFAC") Notice to Policyholders |

Berkley National Insurance Company  
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