C.G.L. [6]

d. Employees as Insured?
- Co-employee exclusion modified?  
  Yes No Remarks

- Professional exclusion modified?  
  Yes No Remarks

e. Blanket Additional Insured, where required by contract?  
  Yes No Remarks

f. Designated Additional Insured (lessor/vendor/etc.)?  
  Yes No Remarks

VI. DEFINITIONS - AMENDED

a. "Bodily Injury" to include mental anguish, mental injury and humiliation?  
  Yes No Remarks

b. "Coverage Territory" to worldwide, if not covered under separate cover?  
  Yes No Remarks

c. "Insured Contract" to:
- Include oral?  
  Yes No Remarks

- Include construction operations on or within 50 feet of railway?  
  Yes No Remarks

- Include indemnification of a municipality?  
  Yes No Remarks

- Include indemnification for fire damage to loaned or rented premises?  
  Yes No Remarks

d. "Mobile Equipment" to include all unlicensed self-propelled vehicles?  
  Yes No Remarks

Definition for Race Track auto?

e. "Personal Injury" to include discrimination/wrongful termination  
  Yes No Remarks

M4 9/87

JOHNSON & HIGGINS

MM 009798