# Schedule of Forms and Endorsements

## Enhanced Commercial Umbrella Liability Policy

| **Named Insured** | **Policy Number** | **Policy Period** |
|------------------|-------------------|-------------------|
| International Business Machines Corporation | G27983212 005 | 05/21/2020 to 05/21/2021 |

| **Endorsement Number** | **Form Number - Edition Date** | **Title** |
|-----------------------|---------------------------------|-----------|
| XSE-52231 (03/19)      | Claims Loss Notification Form   |
| XSE-52226 (03/19)      | Policyholder Notice - Catastrophe Management Coverage |
| 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 |
| ILP 001 (01/04)        | U.S. Treasury Department's Office Of Foreign Assets Control ("OFAC") Advisory Notice To Policyholders |
| 001                    | CC-1K1ii (02/18)                | Signatures |
| 002                    | XSE-50714 (07/18)               | Additional Named Insureds |
| 003                    | XSE-50715a (10/19)              | Aircraft Products And Grounding Hazard Exclusion |
| 004                    | XSE-52219 (04/19)               | Amendatory Endorsement – Various Provisions |
| 005                    | XSE-50717 (07/18)               | Cap On Losses From Certified Acts Of Terrorism |
| 006                    | XSE-52227 (03/19)               | Difference In Conditions / Difference In Limits Endorsement |
| 007                    | TRIA 11d (03/16)                | Disclosure Pursuant To Terrorism Risk Insurance Act |
| 008                    | XSE-52232 (03/19)               | Earlier Notice Of Cancellation Provided By Us |
| 009                    | XSE-50735 (07/18)               | Fellow Employee Exclusion Deleted |
| 010                    | XSE-52234 (03/19)               | Foreign Loss Indemnity Endorsement |
| 011                    | XSE-50741a (05/19)              | Incidental Medical Malpractice Injury |
| 012                    | XSE-50744 (07/18)               | Knowledge Of Occurrence (Designated Persons Or Departments) |
| 013                    | XSE-51212 (10/18)               | New York Changes – Cancellation And Nonrenewal |
| 014                    | XSE-50748 (07/18)               | Notice Of Occurrence Or Claim |

XSE-50763 (07/18)

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