| Policy Type: | Foreign Auto Liability |
| --- | --- |
| Policy Number: |  |
| Policy Period: | 05/21/2016 to 05/21/2017 |
| Carrier: | Retained Limit |
| Limit Amount | Limit Type |
| --- | --- |
| $5,000,000 | Each Occurrence |

| Policy Type: | Foreign Employers Liability |
| --- | --- |
| Policy Number: |  |
| Policy Period: | 05/21/2016 to 05/21/2017 |
| Carrier: | Retained Limit |
| Limit Amount | Limit Type |
| --- | --- |
| $10,000,000 | BI by Accident - Per Accident Limit |
| $10,000,000 | BI by Disease - Policy Limit |
| $10,000,000 | BI by Disease - Each Employee Limit |

In any jurisdiction, state, or province where the amount of Employers Liability Insurance provided by the Underlying Insurer(s) is by law "Unlimited", the underlying Employers Liability limit(s) shown in the above schedule do not apply and no coverage shall be provided for Employers Liability under this policy.

**NOTE:** All scheduled underlying policies must carry a Best rating of A-VI or higher.

**ATTACHED FORMS:**

- ALL-42490 (03/14) U.S. Foreign Account Tax Compliance Act ("FATCA")
- ALL-42490a (02/16) U.S. Foreign Account Tax Compliance Act ("FATCA")
- TR-19604d (01/15) Policyholder Disclosure Notice of Terrorism Insurance Coverage

**ENDORSEMENTS:**

- ALL-23445b (07/13) Policyholder Notice - Commercial Lines Deregulation New York (NY FTZ)
- ALL-20887 (10/06) ACE Producer Compensation Practices and 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 (06/07) Catastrophe Management Notice
- XS-20835 (08/06) Commercial Umbrella Liability Policy
- ALL-25213 (10/08) New York Changes
- TRIA 11c (01/15) Disclosure Pursuant To Terrorism Risk Insurance Act
- XS-15929b (11/14) New York Changes-Cancellation, Nonrenewal
- XS-20745 (08/06) Aircraft Products and Grounding Exclusion
- XS-20756 (08/06) Notice of Occurrence
- XS-20782 (08/06) Cancellation Amendatory Endorsement
- XS-22086 (04/07) Catastrophe Management Coverage Endorsement
- XS-23205 (01/08) New York Changes Endorsement
- XS-23206 (01/08) New York Changes Transfer of Duties When a Limit of Insurance is Used Up
- XS-23501 (04/08) Unintentional Failure to Disclose
- XS-23634 (01/08) Fellow Employee Exclusion Deleted
- XS-23669b (01/15) Cap on Losses From Certified Acts of Terrorism
- XS-24545 (03/08) Named Insured Endorsement
- XS-25254 (02/09) War Exclusion Amendment
- XS-28727a (01/11) Foreign Loss Indemnity Endorsement
- XS-33307a (04/15) Tie In Of Limits Endorsement
- XS-34018 (01/12) Unsolicited Communications Exclusion Amendment to Include FACTA
- XS-35558 (05/13) Difference In Conditions / Difference In Limits Endorsement
- MS-21296 (04/13) Definition of Key Executive Amendatoryl Endorsement

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