# CHUBB Schedule of Forms and Endorsements

## Enhanced Commercial Umbrella Liability Policy

| **Named Insured** | **Policy Number** | **Policy Period** |
|------------------|-------------------|-------------------|
| International Business Machines Corporation | XEU G27983212 008 | 05/21/2023 to 05/21/2024 |

| **Endorsement Number** | **Form Number - Edition Date** | **Title** |
|-----------------------|---------------------------------|-----------|
|                        | TRIA11e (08/20)                 | Disclosure Pursuant to Terrorism Risk Insurance Act |
|                        | ALL-23445b (07/13)              | Policyholder Notice - Commercial Lines Deregulation New York (NYFTZ) |
|                        | XSE - 50761 (07/18)             | Declarations - Enhanced Commercial Umbrella Liability Policy |
|                        | XSE-50764 (07/18)               | Schedule of Retained Limits - Enhanced Commercial Umbrella Liability Policy |
|                        | XSE-51108 (07/18)               | Table of Contents - Enhanced Commercial Umbrella Liability Policy |
|                        | XSE-50762 (05/18)               | Enhanced Commercial Umbrella Liability Policy |
|                        | ALL-20887a (03/16)              | Chubb Producer Compensation Practices & Policies |
|                        | IL P 001 (01/04)                | U.S. Treasury Department's Office Of Foreign Assets Control ("OFAC") Advisory Notice To Policyholders |
|                        | XSE-52226 (03/19)               | Policyholder Notice - Catastrophe Management Coverage |
|                        | XSE-52231 (03/19)               | Claims Loss Notification Form |
| 001                   | CC-1K11k (04/22)                | Signatures |
| 002                   | XSE-53703 (04/20)               | "Scheduled Retained Limit" Amendatory Endorsement (All "Other Insurance" May Reduce Or Erode The "Scheduled Retained Limit") |
| 003                   | XSE-52224a (10/19)             | Access, Collection, Release, or Disclosure of Information; Electronic Data Exclusion – Limited Bodily Injury and Redefined Property Damage Exceptions (Retained Limit) |
| 004                   | XSE-50714 (07/18)               | Additional Named Insureds |
| 005                   | XSE-50715a (10/19)             | Aircraft Products And Grounding Hazard Exclusion |
| 006                   | XSE-51819a (05/20)             | Amendatory Endorsement – New York Changes |
| 007                   | XSE-50717 (07/18)               | Cap On Losses From Certified Acts Of Terrorism |
| 008                   | XSE-52227 (03/19)               | Difference In Conditions / Difference In Limits Endorsement |
| 009                   | XSE-52232 (03/19)               | Earlier Notice Of Cancellation Provided By Us |
| 010                   | XSE-53711 (06/20)               | Enhanced Coverage Self-Insured Retention Amendment (Split Retentions) |
| 011                   | XSE-50735 (07/18)               | Fellow Employee Exclusion Deleted |

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