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Philadelphia Indemnity Insurance Company <br />Form Schedule — Policy <br />Policy Number: PHPK2164330 <br />Forms and Endorsements applying to this Coverage Part and made a part of this <br />policy at time of issue: <br />Form Edition Description <br />WHY MyPHLY <br />0000 <br />WHY MyPHLY? <br />CSNotice-1 <br />0120 <br />Making Things Easier <br />BJP-190-1 <br />1298 <br />Commercial Lines Policy Jacket <br />PI-SAMEX-NOTICE 1 <br />0519 <br />Advisory Notice To Policyholders <br />IL N 177 <br />0912 <br />California Premium Refund Disclosure Notice <br />PI -FEES -NOTICE 1 - <br />0619 <br />Notice Late Fee Reinstatement Fee <br />PP2015 <br />0615 <br />Privacy Policy Notice <br />CPD-PIIC <br />0614 <br />Common Policy Declarations <br />Location Schedule <br />0100 <br />Location Schedule <br />Additional Insured Schedule <br />0100 <br />Additional Insured Schedule <br />Named Insured Sched <br />0100 <br />Named Insured Schedule <br />PI-BELL-1 <br />1109 <br />Bell Endorsement <br />PI-CME-1 <br />1009 <br />Crisis Management Enhancement Endorsement <br />IL0017 <br />1198 <br />Common Policy Conditions <br />IL0021 <br />0908 <br />Nuclear Energy Liability Exclusion Endorsement <br />IL0102 <br />0505 <br />California Changes - Actual Cash Value <br />IL0103 <br />0699 <br />California Changes - Actual Cash Value <br />IL0104 <br />0907 <br />California Changes <br />IL0270 <br />0912 <br />California Changes - Cancellation And Nonrenewal <br />IL0952 <br />0115 <br />Cap On Losses From Certified Acts Of Terrorism <br />PI-ACL-001 <br />1218 <br />Absolute Cyber Liability And Electronic Exclusion <br />PI-SAM-018 <br />0519 <br />Absolute Abuse or Molestation Exclusion <br />PI-TER-DN1 <br />0115 <br />Disclosure Notice Of Terrorism Ins Coverage Rejection <br />Page 1 of <br />R191MwagawdDivision <br />3 REVIEWED&APPROVED BY: <br />EI�WI.�[-L• r'1/.hLN.I R. �kSAAPFC <br />�'. <br />® Risk Mana9emen[Malys[ <br />