# FORMS AND ENDORSEMENTS SCHEDULE

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

| # | Form Number | Form Name |
|---|-------------|-----------|
| 1 | BCIM0300 1113 | Policy Changes Following Form Coverage Endorsement |
| 2 | CEX0001-NY 1014 | Commercial Excess Liability Policy Declarations-New York |
| 3 | BCIM0000 1113 | Forms and Endorsement Schedule |
| 4 | BCIMU0001 1113 | Claim Notice |
| 5 | BCIM0002 1113 | Schedule of Underlying Policies |
| 6 | BCIM0007 1113 | Asbestos Exclusion |
| 7 | BCIM0018 1113 | Crisis Response & Crisis Communication Management Insurance Exclusion |
| 8 | BCIM0064 1113 | Exclusion-Violation of Information Statutes |
| 9 | BCIM0068 1113 | Participation Endorsement |
| 10 | CX 21 01 09 08 | Nuclear Energy Liability Exclusion Endorsement |
| 11 | CX 21 30 01 15 | Cap on Losses from Certified Acts of Terrorism |
| 12 | CX 01 14 06 10 | New York Changes |
| 13 | CX 02 33 06 10 | New York Changes - Cancellation and Nonrenewal |
| 14 | CX 01 15 01 11 | New York Changes-Transfer of Duties When a Limit of Insurance is Used Up |
| 15 | IL 00 17 11 98 | Common Policy Conditions |
| 16 | CX 00 01 04 13 | Commercial Excess Liability Coverage Form |
| 17 | IL DS 77 00 BNLS 04 10 | Signature Page |
| 18 | IL P 001 01 04 | U.S. Treasury Department's Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders |

BCIM0000 1113 Berkley National Insurance Company  
Page 1 of 2