# General Change Endorsement

This endorsement forms a part of and is for attachment to the following designated policy:

- **Affiliated FM Insurance Company**
  - **Policy No:** XL 96794
  - **Endot. No:** 2

**All Terms and Conditions remain unchanged except:**

- Additional premium due now $ (pro rata of $)
- Return premium due now $ (pro rata of $)
- Premium subject to audit.

It is agreed that the Company's limit of liability shall apply excess of loss as follows:

- $5,000,000 per occurrence / $5,000,000 annual aggregate
- Part of $50,000,000 per occurrence / $50,000,000 annual aggregate
- Excess of $80,000,000 per occurrence / $80,000,000 annual aggregate
- Excess of the schedule of underlying insurance described in the policies listed in Item 4 of the Declarations Page.