# NON-FOLLOWING FORM ENDORSEMENT

**THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY.**

It is agreed that:

Coverage under this policy shall not be subject to or follow the provision(s) and/or endorsement(s) of the Followed Policy referenced below.

**Company:** ACE Property and Casualty Insurance Company  
**Policy Number:** XOO G27983212 002  
**Endorsement Number:** As Listed  
**Title:** As Listed  
**Non-Following Provision(s):**

- Catastrophe Management Coverage Endorsement X S-22088 (04/07)
- Uninsured/Underinsured Motorists Coverage Endorsement
- Any Sublimits on the Underlying

This endorsement does not change any other provision of the policy.