The Travelers  
Policy No. 7FSJEX-220T381-9-92  
Issue Date: 08/06/92  

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.  

The endorsement modifies such insurance as is  
afforded by the:  

FOLLOWING FORM EXCESS LIABILITY POLICY  

REJECTION OF UNINSURED MOTORISTS COVERAGE - TENNESSEE  

It is agreed that this policy does not provide Uninsured Motorists Coverage. You have personally, or by your authorized officer indicated below, considered your option, to elect to include Uninsured Motorists Coverage in this policy in an amount equal to the each occurrence Limit of Liability shown on the Declarations Page, or at some lower limit, and have agreed that this policy shall not provide such coverage.

Accepted by:  
(You)  

(Authorized Officer)