**INA**

| Named Insured |  |
| --- | --- |
| Policy Symbol | XCP |
| Policy Number | 144106 |
| Policy Period |  |
| Issued By (Name of Insurance Company) |  |
| Endorsement Number |  |
| Effective Date of Endorsement |  |

**SCHEDULE OF ENDORSEMENTS**

No. 1 Nuclear Energy Liability Exclusion Endorsement  
No. 2 Named Insured Endorsement  
No. 3 Limits of Liability  
No. 4 Item 4 Primary Insurance  
No. 5 Aircraft Products and Grounding Exclusion Endt.  
No. 6 Employee Benefits Liability Endorsement  
No. 7 Data Processing E & O Exclusion

**AUTHORIZED AGENT**

**U.S.A.**

**ORIGINAL**