# CHUBB Schedule of Forms and Endorsements

## Enhanced Commercial Umbrella Liability Policy

| **Named Insured** | **Policy Number** | **Policy Period** |
|------------------|-------------------|-------------------|
| International Business Machines Corporation | XEU G27983212 007 | 05/21/2022 to 05/21/2023 |

| **Endorsement Number** | **Form Number - Edition Date** | **Title** |
|-----------------------|---------------------------------|-----------|
|  | TRIA11e (08/20) | Disclosure Pursuant to Terrorism Risk Insurance Act |
|  | ALL-23445b (07/13) | Policyholder Notice - Commercial Lines Deregulation New York (NYFTZ) |
|  | XSE-50761 (07/18) | Declarations - Enhanced Commercial Umbrella Liability Policy |
|  | XSE-50764 (07/18) | Schedule of Retained Limits - Enhanced Commercial Umbrella Liability Policy |
|  | XSE-51108 (07/18) | Table of Contents - Enhanced Commercial Umbrella Liability Policy |
|  | XSE-50762(05/18) | Enhanced Commercial Umbrella Liability Policy |
|  | ALL-20887a (03/16) | Chubb Producer Compensation Practices & Policies |
|  | IL P 001 (01/04) | U.S. Treasury Department's Office Of Foreign Assets Control ("OFAC") Advisory Notice To Policyholders |
|  | XSE-52226 (03/19) | Policyholder Notice - Catastrophe Management Coverage |
|  | XSE-52231 (03/19) | Claims Loss Notification Form |
| 001 | CC-iK11j (03/21) | Signatures |
| 002 | XSE-53703 (04/20) | "Scheduled Retained Limit" Amendatory Endorsement (All "Other Insurance" May Reduce Or Erode The "Scheduled Retained Limit") |
| 003 | XSE-50714 (07/18) | Additional Named Insureds |
| 004 | XSE-50715a (10/19) | Aircraft Products And Grounding Hazard Exclusion |
| 005 | XSE-51819a (05/20) | Amendatory Endorsement – New York Changes |
| 006 | XSE-52219a (06/20) | Amendatory Endorsement – Various Provisions |
| 007 | XSE-50717 (07/18) | Cap On Losses From Certified Acts Of Terrorism |
| 008 | XSE-52227 (03/19) | Difference In Conditions / Difference In Limits Endorsement |
| 009 | XSE-52232 (03/19) | Earlier Notice Of Cancellation Provided By Us |
| 010 | XSE-53711 (06/20) | Enhanced Coverage Self-Insured Retention Amendment (Split Retentions) |
| 011 | XSE-50735 (07/18) | Fellow Employee Exclusion Deleted |

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