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H I SCOX 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 /> CG 00 01 12 07- General Liability Coverage Form <br /> CGL E5401 CW (03/10)- Definition of Employee <br /> CGL E5403 CW(03/10)- Notice Information <br /> CGL E5404 CW (03/10)- Exclusion - Personal Information <br /> CGL E5407 CW(03/10)- Exclusion - Professional Services <br /> CGL E5408 CW(03/10)- Cancellation Provision (14 Day Full Refund) <br /> CGL E5409 CW(03/10)- Right and Duty to Select Defense Counsel <br /> CGL E5421 CW(02/14)-Additional Insured -Automatic Status <br /> IL 00 17 11 98- Common Policy Conditions <br /> IL 00 21 09 08- Nuclear Energy Liability Exclusion Endorsement(Broad Form) <br /> CG 00 68 05 09- Recording and Distribution of Material or Information in Violation of Law Exclusion <br /> CG 21 41 11 85- Exclusion- Intercompany Products Suits <br /> CG 21 38 11 85- Exclusion- Personal and Advertising Injury <br /> IL 02 70 09 08- California Changes- Cancellation and Nonrenewal <br /> CG 32 34 01 05-California Changes <br /> CGL E5581 CW (03/16)- Primary and Noncontributory-Other Insurance Condition <br /> CGL E5402 CW(03/10)- Modified Waiver of Transfer of Rights of Recovery Against Others To Us <br /> CGL E5405 CW(03/10)- Exclusion- Damage to Primary Residence <br /> IL 09 85 12 20- Disclosure Pursuant To Terrorism Risk Insurance Act <br /> CG 21 70 01 15-Cap On Losses From Certified Acts Of Terrorism <br /> CG 20 26 07 04-Additional Insured - Designated Person or Organization <br /> CGL E1954 CW(05/20)-Asbestos- Exclusion <br /> CGL E1975 CW(05/20)- Limitation of Coverage to Business Operations <br /> CG 21 32 05 09-Communicable Disease Exclusion <br /> CGL E2227 CW(03/23)-Amended War Exclusion <br /> INT N003 CW(01/19)- Policyholder Notice Electronic Delivery <br /> INT N001 CW(01/09)- Economic And Trade Sanctions Policyholder Notice <br /> 40'�--,a R Risk ManagementDivistan <br /> EVI EW &APPROVED ED APPROV BY: <br /> [i(it�` p �.a f}Cevaa <br /> iisminam <br /> Risk Management Specialist <br /> INT D001 01 10 / i ayc i ,i <br />