# Schedule of Forms and Endorsements

## ace group

| NAMED INSURED | POLICY NUMBER | POLICY PERIOD |
|--------------|---------------|---------------|
| International Business Machines Corporation | XOO G2763848A | 05/21/2015 to 05/21/2016 |

| Endorsement Number | Form Number - Edition Date | Title |
|--------------------|----------------------------|-------|
| ALL-23445b (07/13) | Policyholder Notice Commercial Lines Deregulation New York |
| XS-27991 (08/09)   | Schedule Of Forms And Endorsements |
| XS-20835 (08/06)   | ACE Umbrella Plus™ Commercial Umbrella Liability Policy |
| ALL-20887 (10/06)  | ACE Producer Compensation Practices & Policies |
| XS-28500a (08/13)  | ACE Group Specialty Claims Loss Notification Form |
| IL P 001 01 04     | U.S. Treasury Department's Office Of Foreign Assets Control ("OFAC") Advisory Notice To Policyholders |
| XS-22552 (06/2007) | Commercial Umbrella Liability Information For Policyholders To Help You In The Event Of A Claim For Catastrophe Management Coverage |
| 1                  | TRIA11c (01/15)           | Disclosure Pursuant To Terrorism Risk Insurance Act |
| 2                  | CC24180c (03/14)          | Signatures |
| 3                  | XS-43907 (12/14)          | Access, Collection And Disclosure Of Information And Electronic Data Exclusion - Limited Bodily Injury And Redefined Property Damage Exceptions With Retained Limit |
| 4                  | MS-9629 (05/12)           | Aircraft Exclusion With Exception and Self-Insured Retention For Industrial Aid Aircraft |
| 5                  | XS-20745 (08/06)          | Aircraft Products And Grounding Exclusion |
| 6                  | XS-20782 (08/06)          | Cancellation Amendatory Endorsement |
| 7                  | XS23669b (01/15)          | Cap On Losses From Certified Acts Of Terrorism |
| 8                  | XS-22088 (04/07)          | Catastrophe Management Coverage Endorsement |
| 9                  | MS-21296 (04/13)          | Definition of Key Executive Amendatory Endorsement |
| 10                 | XS-35558 (05/13)          | Difference In Conditions / Difference In Limits Endorsement |
| 11                 | MS-9612 (05/12)           | Electronic Chat Rooms or Bulletin Boards Exclusion Endorsement |
| 12                 | MS-9613 (05/12)           | Employee Benefit Plan Follow Form Endorsement [Claims Made] |

XS-27991 (08/09)
© 2009
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