# Allianz

**Policy Number:** USL00197723  
**Effective Date:** May 21, 2023  

## NON FOLLOWING FORM ENDORSEMENT  
AGRL XS ASF 5001 10 20  

This endorsement modifies insurance provided under the following:  

**EXCESS LIABILITY FOLLOWING FORM COVERAGE – SHORT FORM**

This Policy is amended as follows:

Notwithstanding any other provision of this Policy, it is agreed that this Policy shall not provide coverage afforded by the "Followed Policy" for the following:
- Crisis Management or Crisis Response Insurance
- Uninsured/Underinsured (UM/UIM) Insurance
- Liberalization Clause
- Sublimited Coverages

or follow conditions or provisions added to the "Followed Policy" by the following:
- Premium, surcharge or tax allocation or similar endorsement
- Service of Suit clause or endorsement
- State amendatory or state specific endorsement

All other terms and conditions of the Policy remain unchanged.

AGRL XS ASF 5001 10 20  
Copyright © 2020 Allianz Global Risks US Insurance Company. All rights reserved.  
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