# EXCESS OVERLAYER INDEMNITY POLICY

## SECTION 3. SCHEDULE OF UNDERLYING SELF-INSURANCE AND INSURANCE

(Each listed layer of self-insurance and each policy or group of quota-share policies listed is excess of all policies and self-insurance listed below it.)

| LIMITS OF LIABILITY |
| --- | --- |
| EACH OCCURRENCE | AGGREGATE WHERE APPLICABLE |
| POLICY NUMBER | INSURER | $25,000,000 | $25,000,000 |
| LAYER 1 UMBRELLA LIABILITY | TBD | AMERICAN HOME ASSURANCE |

**PRIMARY**

AS PER SCHEDULE OF UNDERLYING INSURANCE SHOWN IN POLICY NO. TBD ISSUED BY AMERICAN HOME ASSURANCE

**CONTROLLING INSURANCE**

TBD | AMERICAN HOME ASSURANCE | UMBRELLA LIABILITY

This schedule applies to the above policies and any renewals or replacements thereof.

XN13203 (11-91)