# Great American Spirit Ins. Company

## Item 10. Policy Forms and Endorsements:

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

| Form Numbers and Editions | Form Description |
|---------------------------|------------------|
| SDM841                    | 07/14            | Policyholder Notification - New York |
| GSD020                    | 01/23            | U.S. Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice To Policyholders |
| USX8030                   | 02/18            | More Than One Followed Policy Endorsement |
| USX8003                   | 02/18            | Schedule of Excess Policy(ies) |
| USX8012                   | 02/18            | Non Following Form Endorsement |
| IL7429                    | 10/21            | New York - Global Sanction Endorsement |
| USX8025                   | 06/20            | Disclosure Pursuant To Terrorism Risk Insurance Act |
| USX8004                   | 02/18            | U.S. Short Excess Form - Coverage Form |
| IL7268                    | 09/09            | In Witness Clause |

USX 8002 (Ed. 02/18)
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