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4v� <br />It is understood and agreed as follows: <br />I. ADDITION OF FORMS OR ENDORSEMENTS <br />CNA Paramount Excess and Umbrella Liability <br />t�oiicy' �cilerauls <br />The Forms and Endorsements Schedule is amended to add the following forms or endorsements effective as <br />of the date set forth in such form or endorsement. <br />Endorsement Form or Endorsement Name <br />Number <br />I15 <br />16 <br />PAYMENT PLAN SCHEDULE <br />DECLARATIONS AMENDMENT ENDORSEMENT <br />AMENDMENT OF FORMS AND ENDORSEMENTS <br />SCHEDULE ADDITION OR DELETION OF <br />ENDORSEMENTS <br />II. DELETION OF FORMS OR ENDORSEMENTS <br />Form Number <br />CNA84401XX <br />CNA71926XX <br />CNA62673XX <br />Edition Date <br />12-2015 <br />04-2013 <br />09-2012 <br />The Forms and Endorsements Schedule is amended to delete the following forms or endorsements effective <br />as of the "deletion date" indicated below. <br />The net premium change, if any, for the above endorsements in Sections I. and II. is: $415,483.00 <br />Surcharge Taxes and Fees changes are (Please note that surcharges and fees are not applicable in <br />New York State): <br />Total change is: <br />All other terms and conditions of the policy remain unchanged. <br />$415,483.00 <br />This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, <br />takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another <br />effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy <br />unless another expiration date is shown below. <br />Form No: CNA62673XX (09-2012) <br />Endorsement Effective Date: 07/30/2021 Endorsement Expiration Date: <br />Endorsement No: 16; Page: 1 of 1 <br />Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 <br />® Copyright CNA All Rights Reserved. <br />rid- fir, <br />Rlele Mmagem enf Dh islan <br />REVIEWED 6 APPROVED BY: <br />` 9ai1�1111� - <br />99'. <br />A+.j;,"410 <br />- <br />Rtsk Management Spedallst <br />