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HISCOX HISCOX INSURANCE COMPANY INC. (A Stock Company) <br />encourage courage 104 South Michigan Avenue, Suite 600, Chicago, Illinois 60603 <br />Forms and Endorsements Schedule <br />Forms and Endorsements made part of this policy at time of issue: <br />CGL D001 10 18 - Commercial General Liability Declarations <br />INT D001 01 10 - Forms and Endorsements Schedule <br />CGL E5410 CW (03110) - Policy Changes <br />CG 20 26 07 04 - Additional Insured - Designated Person or Organization <br />INT D001 01 10 <br />n <br />Risk MatagemodDMstan <br />REVIE &APPRw Br. <br />`®' <br />Ruk Management Sped4ist <br />