# Document Title: Disclosure Pursuant to Terrorism Risk Insurance Act

**Endorsement Number:** GAI 6472 (Ed 01 OBI)

**Issuing Company:** Great American Insurance Group
**Address:** Administrative Offices, 580 Walnut Street, Cincinnati, Ohio 45202
**Phone:** 1-513-398-0300

**Endorsement Description:**
This endorsement is attached to and made part of your policy in response to the disclosure requirements of the Terrorism Risk Insurance Act. This endorsement does not grant any coverage or change the terms and conditions of any coverage under the policy.

**Coverage Affected:**
This endorsement modifies insurance provided under the following:
- Commercial Umbrella Coverage Form
- SafePak® Umbrella Liability Coverage Form
- Excess Liability

**Terrorism Premium (Certified Acts): $ 394**

* Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

### A. Disclosure Of Premium
In accordance with the federal Terrorism Risk Insurance Act, we are required to provide you with a notice disclosing the portion of your premium, if any, attributable to coverage for terrorist acts certified under the Terrorism Risk Insurance Act. The portion of your premium attributable to such coverage is shown in the Schedule of this endorsement or in the policy Declarations.

### B. Disclosure Of Federal Participation In Payment Of Terrorism Losses
The United States Government, Department of the Treasury, will pay a share of terrorism losses insured under the federal program. The federal share equals 85% of that portion of the amount of such insured losses that exceeds the applicable insurer retention. However, if aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed $100 billion in a Program Year (January 1 through December 31) the Treasury shall not make any payment for any portion of the amount of such losses that exceeds $100 billion.

### C. Cap On Insurer Participation In Payment Of Terrorism Losses
If aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed $100 billion in a Program Year (January 1 through December 31) and we have met our insurer deductible under the Terrorism Risk Insurance Act, we shall not be liable for the payment of any portion of the amount of such losses that exceeds $100 billion, and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury.

**Endorsement Note:**
This endorsement does not change any other provision of the policy.

**Copyright Notice:**
Includes copyrighted material of ISO Properties, Inc., with its permission.
GAI 6472 (Ed 01/OBI PRO)
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