**Premium Adjustment:**
- None
- In Policy Premium
- Additional $ [Amount]
- Return $ [Amount]

**Payable:**
- Advance: $ [Amount]
- First Installment: $ [Amount]
- Second Installment: $ [Amount]

**Data Processors Errors & Omissions Exclusion**

Coverage does not apply under this policy:
"To claims arising out of Data Processors Errors and Omissions Liability Coverage as is afforded by specific errors and omissions policies, or special manuscript policies, or endorsements by which DataProcessors Errors and Omissions Coverage is or is not specifically added to standard policies whether such policies are attached to the schedule of underlying insurance as stated in the policy or not."

This supplement, which forms a part of and is for attachment to the following described policy issued by the company designated therein, takes effect on the effective date of said policy, unless another effective date is shown below, at the hour stated in said policy and expires concurrently with said policy.

**Must Be Completed**
- SUPPL. NO.: 6
- POLICY NO.: RDX 1775213

**Complete Only When This Supplement Is Not Prepared with the Policy Or Is Not to be Effective with the Policy**
- ISSUED TO: [Name]
- EFFECTIVE DATE OF THIS SUPPLEMENT: [Date]

**Countersigned by:** [Signature]