| Title | Form # | Ed. | Restriction in Coverage from Prior Year | Comments |
|---|---|---|---|---|
| EARLIER NOTICE OF CANCELLATION AND NON-RENEWAL | ALL10617b | 0614 | 90: 90 | |
| EMPLOYEES AS INSUREDS | CA9933 | 1013 | | |
| FELLOW EMPLOYEE COVERAGE | CA2055 | 1013 | Number of Employees o | |
| HIRED AUTOS SPECIFIED AS COVERED AUTOS YOU OWN | CA9916 | 1013 | All autos hired for a period of 180 days or longer | |
| KNOWLEDGE OF AN ACCIDENT | DA5X68b | 0614 | Vice President of IBM Risk & Insurance | |
| KY LOCAL GOVERNMENT PREMIUM TAX SCHEDULE | ALL32677a | 0412 | Tax Code: -1 Tax Amount:$ o | |
| MEXICO COVERAGE ENDORSEMENT | DA9T51 | 0793 | | |
| MOTOR CARRIER ENDORSEMENT | MCS90 | 0621 | Primary; 5,000,000 Limit | |
| NEW YORK DEDUCTIBLE ENDORSEMENT FULL ALAE REIMBURSEMENT, DEDUCTIBLE EQUALS LIMIT | DA49396 | 0617 | Deductible: 5,000,000 | |
| NON-CONTRIBUTORY FOR ADDITIONAL INSUREDS | DA21886b | 0614 | Any additional insured with whom you have agreed to provide such non-contributory insurance, pursuant to and as required under a written contract executed prior to the date of loss. | |
| NOTICE TO OTHERS ENDORSEMENT - SPECIFIC PARTIES | ALL32688 | 0111 | Name: Los Angeles Department of Water and Power, Risk Management Section; Address: PO Box 51111, Room 465-JFB, Los Angeles, CA 90051-0100 | |
| NOTIFICATION OF PREMIUM ADJUSTMENT | ALL18057 | 1211 | | |
| NUCLEAR ENERGY LIABILITY EXCLUSION | IL0021 | 0908 | | |
| PUBLIC ENTITY ADDITIONAL INSURED | ALL22422 | 0507 | Los Angeles Department of Water and Power, Risk Management Section, P.O. Box 51111, Rm 465, Los Angeles, California 90051-0100 | |
| TRADE OR ECONOMIC SANCTIONS ENDORSEMENT | ALL21101 | 1106 | | |
| UNINSURED MOTORISTS AND UNDERINSURED MOTORISTS COVERAGE SUMMARY | DA40002 | 0413 | 1. MI, OH, PR; 2. AL, AK, AZ, AR, CA, CO, DE, FL, GA, HI, ID, IN, IA, KY, LA, MS, MT, NV, NM, OK, PA, TN, TTX, UT, WA, WY; 3. All states not listed in items 1,2 or 4 of this form; 4. The policy limit for liability shall apply for vehicles principally garaged or registered in the state of NH. | |