# Schedule of Forms and Endorsements

**ace group**

| NAMED INSURED | POLICY NUMBER | POLICY PERIOD |
|---------------|---------------|---------------|
| International Business Machines Corporation | XOO G25915951 | 05/21/2012 to 05/21/2013 |

| Endorsement Number | Form Number - Edition Date | Title |
|--------------------|----------------------------|-------|
| XS-20835 (08/06)   | Commercial Umbrella Liability Policy |
| IL P 001 (01/04)   | U.S. Treasury Department's Office of Foreign Assets Control ("OFAC") Advisory Notice To Policyholders |
| ALL-20887 (10/06)  | ACE Producer Compensation Practices & Policies |
| XS-28500 (10/09)   | ACE Groups Specialty Claims Loss Notification Form |
| XS-22552 (06/07)   | Catastrophe Management Policyholder Notice |
| 1                  | CC-24180b (01/11)          | Signatures |
| 2                  | XS-20745 (08/06)            | Aircraft Products And Grounding Exclusion |
| 3                  | XS-20756 (08/06)            | Notice Of Occurrence |
| 4                  | XS-20782 (08/06)            | Cancellation Amendatory Endorsement |
| 5                  | XS-22088 (04/07)            | Catastrophe Management Coverage Endorsement |
| 6                  | XS-23205 (01/08)            | New York Changes Endorsement |
| 7                  | XS-23206 (01/08)            | NYFTZ-New York Changes Transfer Of Duties When A Limit Of Insurance |
| 8                  | XS-23634 (01/08)            | Fellow Employee Exclusion Deleted |
| 9                  | XS-24545 (03/08)            | Named Insured Endorsement |
| 10                 | XS-23501 (04/08)            | Unintentional Failure to Disclose |
| 11                 | XS-25254 (02/09)            | War Exclusion |
| 12                 | XS-28727a (01/11)           | Foreign Loss Indemnity Endorsement |
| 13                 | TRIA11b (01/08)             | Disclosure Pursuant To Terrorism Risk Insurance Act |
| 14                 | XS-23669 (01/08)            | Cap On Losses From Certified Acts Of Terrorism |
| 15                 | ALL-25213 (10/08)           | New York Changes |
| 16                 | XS-15929a (09/09)           | New York Changes-Cancellation, Nonrenewal |
| 17                 | MS-9625 (05/12)             | Who Is An Insured Amendatory Endorsement |
| 18                 | MS-9609 (05/12)             | Aircraft Exclusion with Exception and Self-Insured Retention for Industrial |

**CLASS CODE 2-13000**

**NOTICE:** THESE POLICY FORMS AND THE APPLICABLE RATES ARE EXEMPT FROM THE FILING REQUIREMENTS OF THE NEW YORK STATE INSURANCE DEPARTMENT. HOWEVER SUCH FORMS AND RATES MUST MEET THE MINIMUM STANDARDS OF THE NEW YORK INSURANCE LAW AND REGULATIONS.

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